Mortality in Patients with Pituitary Disease

Mark Sherlock, John Ayuk, Jeremy Tomlinson, Andrew Toogood, Aurora Aragon Alonso, Michael Sheppard, Andrew Bates, Paul Stewart

Research output: Contribution to journalReview article

242 Citations (Scopus)


Pituitary disease is associated with increased mortality predominantly due to vascular disease. Control of cortisol secretion and GH hypersecretion (and cardiovascular risk factor reduction) is key in the reduction of mortality in patients with Cushing's disease and acromegaly, retrospectively. For patients with acromegaly, the role of IGF-I is less clear-cut. Confounding pituitary hormone deficiencies such as gonadotropins and particularly ACTH deficiency (with higher doses of hydrocortisone replacement) may have a detrimental effect on outcome in patients with pituitary disease. Pituitary radiotherapy is a further factor that has been associated with increased mortality (particularly cerebrovascular). Although standardized mortality ratios in pituitary disease are falling due to improved treatment, mortality for many conditions are still elevated above that of the general population, and therefore further measures are needed. Craniopharyngioma patients have a particularly increased risk of mortality as a result of the tumor itself and treatment to control tumor growth; this is a key area for future research in order to optimize the outcome for these patients. (Endocrine Reviews 31: 301-342, 2010)
Original languageEnglish
Pages (from-to)301-342
Number of pages42
JournalEndocrine Reviews
Issue number3
Publication statusPublished - 1 Jun 2010


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