COVID19 infection and vaccination and the risk of pituitary apoplexy: an entangled yarn.

COVID19 COVID19 vaccine Hypophysis Hypopituitarism Pituitary gland Transsphenoidal surgery

Journal

Endocrine
ISSN: 1559-0100
Titre abrégé: Endocrine
Pays: United States
ID NLM: 9434444

Informations de publication

Date de publication:
21 Oct 2024
Historique:
received: 07 07 2024
accepted: 09 10 2024
medline: 22 10 2024
pubmed: 22 10 2024
entrez: 21 10 2024
Statut: aheadofprint

Résumé

Pituitary apoplexy (PA) has been increasingly reported in association with both infection from and vaccination for COVID19. Our aim was to analyse the available published cases and compare the clinical characteristics in the two groups (infection vs vaccination). We systematically reviewed the published literature for all cases of PA associated with COVID19 infection or vaccination. We also presented two cases managed at our Centre. Collectively, fortythree cases were analysed. Patients with PA after COVID19 vaccination (n = 7), compared with patients with PA after COVID19 infection (n = 36), were significantly younger (p = 0.009) and had a more abrupt onset of PA (p = 0.022), but showed a milder hormonal involvement (p = 0.008) and a lower rate of persistent hypopituitarism during follow-up (p = 0.001). Patients in the vaccination group did not have clinical risk factors for PA, although this difference did not reach statistical significance. PA associated with COVID19 is a rare but clinically significant entity, although pathophysiological details of this association are lacking. Given the significantly different clinical presentation, we could speculate that PA induced by COVID19 vaccination might represent a distinct clinical entity, with different pathophysiological mechanism, compared to PA from COVID19 infection.

Identifiants

pubmed: 39433700
doi: 10.1007/s12020-024-04078-7
pii: 10.1007/s12020-024-04078-7
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Références

Z.C. Hannoush, R.E. Weiss “Pituitary Apoplexy.,” In: Feingold K.R., Anawalt B., Blackman M.R., Boyce A., Chrousos G., Corpas E., de Herder W.W., Dhatariya K., Dungan K., Hofland J., et al., editors. Endotext. South Dartmouth [MA]: MDText.com, Inc. [2018] http://www.ncbi.nlm.nih.gov/books/NBK279125/ [Accessed June 22, 2024]
N. Muthukumar, Pituitary apoplexy: A comprehensive review. Neurol. India 68, S72–S78 (2020). https://doi.org/10.4103/0028-3886.287669
doi: 10.4103/0028-3886.287669 pubmed: 32611895
B. Biagetti, R. Simò, Pituitary apoplexy: Risk factors and underlying molecular mechanisms. Int. J. Mol. Sci. 23, 8721 (2022). https://doi.org/10.3390/ijms23158721
doi: 10.3390/ijms23158721 pubmed: 35955859 pmcid: 9369054
C. Hazzi, N. Villemure-Poliquin, S. Nadeau, P.-O. Champagne, SARS-CoV-2 infection, a risk factor for pituitary apoplexy? A case series and literature review. Ear Nose Throat J. 103, 153S–161S (2024). https://doi.org/10.1177/01455613231179714
doi: 10.1177/01455613231179714 pubmed: 37291861
K.A. Aghdam, Z.-A. Abtahi, S.A. Sonbolestan, M.S. Sanjari, Pituitary apoplexy secondary to thrombocytopenia due to severe acute respiratory syndrome coronavirus 2 infection: report of a rare case and literature review. J. Curr. Ophthalmol. 34, 364–368 (2022). https://doi.org/10.4103/joco.joco_321_21
doi: 10.4103/joco.joco_321_21 pubmed: 36644472 pmcid: 9832454
W.A. Kamel, M. Najibullah, M.S. Saleh, W.A. Azab, Coronavirus disease 2019 infection and pituitary apoplexy: A causal relation or just a coincidence? A case report and review of the literature. Surg. Neurol. Int 12, 317 (2021). https://doi.org/10.25259/SNI_401_2021
doi: 10.25259/SNI_401_2021 pubmed: 34345458 pmcid: 8326077
R. Martinez-Perez, M.W. Kortz, B.W. Carroll, D. Duran, J.S. Neill, G.D. Luzardo, M.A. Zachariah, Coronavirus disease 2019 and pituitary apoplexy: A single-center case series and review of the literature. World Neurosurg. 152, e678–e687 (2021). https://doi.org/10.1016/j.wneu.2021.06.004
doi: 10.1016/j.wneu.2021.06.004 pubmed: 34129968 pmcid: 8196470
S. Rahman, M.T.V. Montero, K. Rowe, R. Kirton, F. Kunik, Epidemiology, pathogenesis, clinical presentations, diagnosis and treatment of COVID-19: a review of current evidence. Expert Rev. Clin. Pharm. 14, 601–621 (2021). https://doi.org/10.1080/17512433.2021.1902303
doi: 10.1080/17512433.2021.1902303
E.M. Conway, N. Mackman, R.Q. Warren, A.S. Wolberg, L.O. Mosnier, R.A. Campbell, L.E. Gralinski, M.T. Rondina, F.L. van de Veerdonk, K.M. Hoffmeister et al. Understanding COVID-19-associated coagulopathy. Nat. Rev. Immunol. 22, 639–649 (2022). https://doi.org/10.1038/s41577-022-00762-9
doi: 10.1038/s41577-022-00762-9 pubmed: 35931818 pmcid: 9362465
A. Bonaventura, A. Vecchié, L. Dagna, K. Martinod, D.L. Dixon, B.W. Van Tassell, F. Dentali, F. Montecucco, S. Massberg, M. Levi et al. Endothelial dysfunction and immunothrombosis as key pathogenic mechanisms in COVID-19. Nat. Rev. Immunol. 21, 319–329 (2021). https://doi.org/10.1038/s41577-021-00536-9
doi: 10.1038/s41577-021-00536-9 pubmed: 33824483 pmcid: 8023349
L. Aliberti, I. Gagliardi, R. Rizzo, D. Bortolotti, G. Schiuma, P. Franceschetti, R. Gafà, L. Borgatti, M.A. Cavallo, M.C. Zatelli et al. Pituitary apoplexy and COVID-19 vaccination: a case report and literature review. Front Endocrinol. [Lausanne] 13, 1035482 (2022). https://doi.org/10.3389/fendo.2022.1035482
doi: 10.3389/fendo.2022.1035482
M. Verrienti, V. Marino Picciola, M.R. Ambrosio, M.C Zatelli, Pituitary and COVID-19 vaccination: a systematic review. Pituitary [2024] https://doi.org/10.1007/s11102-024-01402-2
A. Ragni, G. Bendotti, E. Biamonte, B. Cavigiolo, E. Gabellieri, P. Leporati, E.L.M. Mollero, M Gallo, SARS-Cov-2 infection: A new risk factor for pituitary apoplexy? Endocr. Metab. Immune Disord. Drug Targets [2024] https://doi.org/10.2174/0118715303315494240419060719
M.J. Page, J.E. McKenzie, P.M. Bossuyt, I. Boutron, T.C. Hoffmann, C.D. Mulrow, L. Shamseer, J.M. Tetzlaff, E.A. Akl, S.E. Brennan et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372, n71 (2021). https://doi.org/10.1136/bmj.n71
doi: 10.1136/bmj.n71 pubmed: 33782057 pmcid: 8005924
H. Tanaka, F. Nishimura, K. Nakase, S. Yokoyama, I. Nakagawa, S. Yamada, K. Tamura, R. Matsuda, Y. Takeshima, M. Kotsugi et al. Case report: Giant pituitary neuroendocrine tumor presented along with acute visual loss due to pituitary apoplexy after receiving COVID-19 vaccination. Front. Surg. 10, 1220098 (2023). https://doi.org/10.3389/fsurg.2023.1220098
doi: 10.3389/fsurg.2023.1220098 pubmed: 37576925 pmcid: 10413133
N.A. Zainordin, S.F.W.M. Hatta, N. Ab Mumin, F.Z.M. Shah, R.A. Ghani, Pituitary apoplexy after COVID-19 vaccination: A case report. J. Clin. Transl. Endocrinol. Case Rep. 25, 100123 (2022). https://doi.org/10.1016/j.jecr.2022.100123
doi: 10.1016/j.jecr.2022.100123 pubmed: 35942396 pmcid: 9351216
A. Piñar-Gutiérrez, P. Remón-Ruiz, A. Soto-Moreno, Case report: Pituitary apoplexy after COVID-19 vaccination. Med. Clin. [Engl. Ed.] 158, 498–499 (2022). https://doi.org/10.1016/j.medcle.2021.09.021
doi: 10.1016/j.medcle.2021.09.021
L. Roncati, A. Manenti, Pituitary apoplexy following adenoviral vector-based COVID-19 vaccination. Brain Hemorrhages 4, 27–29 (2023). https://doi.org/10.1016/j.hest.2022.04.002
doi: 10.1016/j.hest.2022.04.002 pubmed: 35464129
J. Shirin, A rare endocrine complication of the COVID-19 Vaccine. Endocr. Pract. 27, 116–117 (2021). https://doi.org/10.1016/j.eprac.2021.04.716
doi: 10.1016/j.eprac.2021.04.716
M.F. Yusof, J. Noor, Pituitary apoplexy with hypophysitis following ChAdOx1 nCoV-19 [AZD1222] vaccination: a potential culprit?
G. Racca, S. D’Agnano, N. Fasano, L. Gianotti, Pituitary apoplexy with transition to acute hypophysitis in a patient with Sars-CoV-2 Pneumonia. JCEM Case Rep. 1, luac010 (2023). https://doi.org/10.1210/jcemcr/luac010
doi: 10.1210/jcemcr/luac010 pubmed: 37908272
M. Corn, A. Nickell, C. Lessard, A. Jackson, Pituitary apoplexy during pregnancy with transsphenoidal resection and intraoperative fetal monitoring: A case report. Case Rep. Women’s. Health 39, e00543 (2023). https://doi.org/10.1016/j.crwh.2023.e00543
doi: 10.1016/j.crwh.2023.e00543
H. Hussain, K. Janaka, D.T. Muthukuda, S.G. Perera, Pituitary apoplexy as a complication of COVID-19 infection. Cureus 15, e43524 (2023). https://doi.org/10.7759/cureus.43524
doi: 10.7759/cureus.43524 pubmed: 37719628 pmcid: 10500954
D. Popov, A. Hadzhiyanev, Pituitary apoplexy associated with COVID-19 infection: review and a case report. Biotechnol. Biotechnol. Equip. 36, 75–81 (2022). https://doi.org/10.1080/13102818.2022.2051738
doi: 10.1080/13102818.2022.2051738
Y. Yachou, A. El Idrissi, V. Belapasov, S. Ait Benali, Neuroinvasion, neurotropic, and neuroinflammatory events of SARS-CoV-2: understanding the neurological manifestations in COVID-19 patients. Neurol. Sci. 41, 2657–2669 (2020). https://doi.org/10.1007/s10072-020-04575-3
doi: 10.1007/s10072-020-04575-3 pubmed: 32725449 pmcid: 7385206
A.M. Poma, A. Basolo, D. Bonuccelli, A. Toniolo, SARS-CoV-2 spread to endocrine organs is associated with obesity: an autopsy study of COVID-19 cases. Endocrine 83, 110–117 (2024). https://doi.org/10.1007/s12020-023-03518-0
doi: 10.1007/s12020-023-03518-0 pubmed: 37698811
A. Greinacher, T. Thiele, T.E. Warkentin, K. Weisser, P.A. Kyrle, S. Eichinger, Thrombotic thrombocytopenia after ChAdOx1 nCov-19 vaccination. N. Engl. J. Med. 384, 2092–2101 (2021). https://doi.org/10.1056/NEJMoa2104840
doi: 10.1056/NEJMoa2104840 pubmed: 33835769
A. Gómez-Roldós, M. González-Sánchez, M. Vales-Montero, P. Vázquez-Alen, Y. Fernández-Bullido, A.M. Iglesias-Mohedano, F. Díaz-Otero, A. García-Pastor, A. Gil-Núñez, Fatal intracerebral haemorrhage associated with thrombosis with thrombocytopenia syndrome after ChAdOx1-S vaccine. Rev. Neurol. 75, 199–202 (2022). https://doi.org/10.33588/rn.7507.2021323
doi: 10.33588/rn.7507.2021323 pubmed: 36169326 pmcid: 10280759
K.J. Welsh, J. Baumblatt, W. Chege, R. Goud, N. Nair, Thrombocytopenia including immune thrombocytopenia after receipt of mRNA COVID-19 vaccines reported to the Vaccine Adverse Event Reporting System [VAERS]. Vaccine 39, 3329–3332 (2021). https://doi.org/10.1016/j.vaccine.2021.04.054
doi: 10.1016/j.vaccine.2021.04.054 pubmed: 34006408 pmcid: 8086806
M. Goldman, C. Hermans, Thrombotic thrombocytopenia associated with COVID-19 infection or vaccination: Possible paths to platelet factor 4 autoimmunity. PLoS Med 18, e1003648 (2021). https://doi.org/10.1371/journal.pmed.1003648
doi: 10.1371/journal.pmed.1003648 pubmed: 34029337 pmcid: 8153497
A. Vojdani, D. Kharrazian, Potential antigenic cross-reactivity between SARS-CoV-2 and human tissue with a possible link to an increase in autoimmune diseases. Clin. Immunol. 217, 108480 (2020). https://doi.org/10.1016/j.clim.2020.108480
doi: 10.1016/j.clim.2020.108480 pubmed: 32461193 pmcid: 7246018
Y.T. Lawrence, L. Bacal, A. Krikorian, A novel association between pituitary tumor apoplexy and influenza A. AACE Clin. Case Rep. 2, 143–145 (2016). Doi:10.4158/EP15657.CR
H.S. Alyami, M.M. Al Wadany, A.S. Almousa, E.A. Khawaji, A.M. Almousa, M.A. Albaqshi, A.S. Alharbi, Pituitary apoplexy with pituitary macroadenoma in a patient with asymptomatic COVID-19: A case report. Cureus 14, e32810 (2022). https://doi.org/10.7759/cureus.32810
doi: 10.7759/cureus.32810 pubmed: 36694516 pmcid: 9860463
J. Balmain, M. Jarebi, A. Al-Salameh, P. Toussaint, M. Timmerman, L. Chenin, J.-M. Constans, R. Desailloud, Pituitary apoplexy in the aftermath of a SARS-CoV-2 infection: a case series from Amiens University Hospital. Eur. J. Endocrinol. 187, 19–25 (2022). https://doi.org/10.1530/EJE-22-0056
doi: 10.1530/EJE-22-0056
C. Taneja, P.K. Fazeli, P.A. Gardner, E.W. Wang, C.H. Snyderman, H. Mahmud, Rapidly progressive pituitary apoplexy in a patient with COVID-19 disease treated with endoscopic endonasal surgery. J. Neurol. Surg. Rep. 83, e8–e12 (2022). https://doi.org/10.1055/s-0041-1742104
doi: 10.1055/s-0041-1742104 pubmed: 35028278 pmcid: 8747894
S.-Y. Liew, R. Seese, A. Shames, K. Majumdar, Apoplexy in a previously undiagnosed pituitary macroadenoma in the setting of recent COVID-19 infection. BMJ Case Rep. 14, e243607 (2021). https://doi.org/10.1136/bcr-2021-243607
doi: 10.1136/bcr-2021-243607 pubmed: 34321266 pmcid: 8319972
S.J. Bordes, S. Phang-Lyn, E. Najera, H. Borghei-Razavi, B. Adada, Pituitary apoplexy attributed to COVID-19 infection in the absence of an underlying macroadenoma or other identifiable cause. Cureus 13, e13315 (2021). https://doi.org/10.7759/cureus.13315
doi: 10.7759/cureus.13315 pubmed: 33732566 pmcid: 7956048
V. Katti, L.B. Ramamurthy, S. Kanakpur, S.D. Shet, M. Dhoot, Neuro-ophthalmic presentation of COVID-19 disease: A case report. Indian J. Ophthalmol. 69, 992–994 (2021). https://doi.org/10.4103/ijo.IJO_3321_20
doi: 10.4103/ijo.IJO_3321_20 pubmed: 33727476 pmcid: 8012961
M. LaRoy, M. McGuire, Pituitary apoplexy in the setting of COVID-19 infection. Am. J. Emerg. Med 47, 329.e1–329.e2 (2021). https://doi.org/10.1016/j.ajem.2021.02.045
doi: 10.1016/j.ajem.2021.02.045 pubmed: 33658149
R. Ghosh, D. Roy, D. Roy, A. Mandal, A. Dutta, D. Naga, J. Benito-León, A rare case of SARS-CoV-2 infection associated with pituitary apoplexy without comorbidities. J. Endocr. Soc. 5, bvaa203 (2021). https://doi.org/10.1210/jendso/bvaa203
doi: 10.1210/jendso/bvaa203 pubmed: 33501401 pmcid: 7798947
S. Solorio-Pineda, C.A. Almendárez-Sánchez, A.A. Tafur-Grandett, G.A. Ramos-Martínez, R. Huato-Reyes, M.I. Ruiz-Flores, A. Sosa-Najera, Pituitary macroadenoma apoplexy in a severe acute respiratory syndrome-coronavirus-2-positive testing: Causal or casual? Surg. Neurol. Int 11, 304 (2020). https://doi.org/10.25259/SNI_305_2020
doi: 10.25259/SNI_305_2020 pubmed: 33093981 pmcid: 7568102
J.L. Chan, K.D. Gregory, S.S. Smithson, M. Naqvi, A.N. Mamelak, Pituitary apoplexy associated with acute COVID-19 infection and pregnancy. Pituitary 23, 716–720 (2020). https://doi.org/10.1007/s11102-020-01080-w
doi: 10.1007/s11102-020-01080-w pubmed: 32915365 pmcid: 7484495
V. Babu, J. Burks, S. Malik, K. Sapru, A rare case of pituitary apoplexy associated with COVID infection presenting with Central Diabetes Insipidus. Endocr. Pract. 28, 111 (2022). https://doi.org/10.1016/j.eprac.2022.03.263
doi: 10.1016/j.eprac.2022.03.263
N. Premarathna, A. Fernando, S. Bandusena, C. Lokubalasooriya, N. Vithanage, Covid 19 related acute necrotizing encephalopathy complicated with pituitary apoplexy. Neuroepidemiology [2022] 56: https://doi.org/10.1159/000523776
N. Mascarenhas, C.L. Alves, A. Campagnoli, D. Pedro, Pituitary apoplexy in a COVID-19 patient. Abstract Book, 17th. World Congr. Anaesthesiologists 133, 1–1973 (2021). https://doi.org/10.1213/01.ane.0000791544.44545.82
doi: 10.1213/01.ane.0000791544.44545.82
C. Lesniak, K. Hu, M. Akula, K. Zin, R. Ong, S. Holland, J. Cheng, Pituitary apoplexy presenting in a COVID-19 positive patient as ophthalmoplegia. Endocr. Pract. 27, 115–116 (2021). https://doi.org/10.1016/j.eprac.2021.04.714
doi: 10.1016/j.eprac.2021.04.714
J.C. De La Flor Merino, L.M. Reyes, T. Linares Gravalos, A. Roel Conde, M. Rodeles del Pozo, An unusual case of severe acute hyponatremia in patient with COVID-19 infection. Nefrologia [Engl. Ed.] 40, 356–358 (2020). https://doi.org/10.1016/j.nefroe.2020.06.015
doi: 10.1016/j.nefroe.2020.06.015 pubmed: 32439187

Auteurs

Alberto Ragni (A)

Endocrinology and Metabolic Diseases Unit, SS. Antonio e Biagio e Cesare Arrigo Teaching Hospital, Alessandria, Italy. alberto.ragni@ospedale.al.it.

Emilia Biamonte (E)

Endocrinology and Metabolic Diseases Unit, SS. Antonio e Biagio e Cesare Arrigo Teaching Hospital, Alessandria, Italy.

Beatrice Cavigiolo (B)

Endocrinology Unit, Maggiore della Carità Teaching Hospital, University of Eastern Piedmont, Novara, Italy.

Edoardo Luigi Maria Mollero (ELM)

Endocrinology Unit, Maggiore della Carità Teaching Hospital, University of Eastern Piedmont, Novara, Italy.

Giulia Bendotti (G)

Endocrinology and Metabolic Diseases Unit, SS. Antonio e Biagio e Cesare Arrigo Teaching Hospital, Alessandria, Italy.

Enrico Gabellieri (E)

Endocrinology and Metabolic Diseases Unit, SS. Antonio e Biagio e Cesare Arrigo Teaching Hospital, Alessandria, Italy.

Paola Leporati (P)

Endocrinology and Metabolic Diseases Unit, SS. Antonio e Biagio e Cesare Arrigo Teaching Hospital, Alessandria, Italy.

Marco Gallo (M)

Endocrinology and Metabolic Diseases Unit, SS. Antonio e Biagio e Cesare Arrigo Teaching Hospital, Alessandria, Italy.

Classifications MeSH