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Clinical characteristics of pain in patients with pituitary adenomas.

Abstract：

OBJECTIVE:Clinical presentation of pituitary adenomas frequently involves pain, particularly headache, due to structural and functional properties of the tumour. Our aim was to investigate the clinical characteristics of pain in a large cohort of patients with pituitary disease. DESIGN:In a cross-sectional study, we assessed 278 patients with pituitary disease (n=81 acromegaly; n=45 Cushing's disease; n=92 prolactinoma; n=60 non-functioning pituitary adenoma). METHODS:Pain was studied using validated questionnaires to screen for nociceptive vs neuropathic pain components (painDETECT), determine pain severity, quality, duration and location (German pain questionnaire) and to assess the impact of pain on disability (migraine disability assessment, MIDAS) and quality of life (QoL). RESULTS:We recorded a high prevalence of bodily pain (n=180, 65%) and headache (n=178, 64%); adrenocorticotropic adenomas were most frequently associated with pain (n=34, 76%). Headache was equally frequent in patients with macro- and microadenomas (68 vs 60%; P=0.266). According to painDETECT, the majority of the patients had a nociceptive pain component (n=193, 80%). Despite high prevalence of headache, 72% reported little or no headache-related disability (MIDAS). Modifiable factors including tumour size, genetic predisposition, previous surgery, irradiation or medical therapy did not have significant impact neither on neuropathic pain components (painDETECT) nor on headache-related disability (MIDAS). Neuropathic pain and pain-related disability correlated significantly with depression and impaired QoL. CONCLUSIONS:Pain appears to be a frequent problem in pituitary disease. The data suggest that pain should be integrated in the diagnostic and therapeutic work-up of patients with pituitary disease in order to treat them appropriately and improve their QoL.

journal_name

Eur J Endocrinol

journal_title

European journal of endocrinology

authors

Dimopoulou C,Athanasoulia AP,Hanisch E,Held S,Sprenger T,Toelle TR,Roemmler-Zehrer J,Schopohl J,Stalla GK,Sievers C

doi

10.1530/EJE-14-0375

subject

Has Abstract

pub_date

2014-11-01 00:00:00

pages

581-91

issue

eissn

0804-4643

issn

1479-683X

pii

EJE-14-0375

journal_volume

171

pub_type

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Clinical characteristics of pain in patients with pituitary adenomas.