The Experts below are selected from a list of 507 Experts worldwide ranked by ideXlab platform
Lucilla Pascolini - One of the best experts on this subject based on the ideXlab platform.
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'Empty Sella Syndrome': a case of a patient with sodium succinate hydrocortisone allergy
European Journal of Endocrinology, 2010Co-Authors: Eleonora Nucera, Amira Colagiovanni, Valentina Pecora, Vito Sabato, Angela Rizzi, Arianna Aruanno, C. Lombardo, Alessandro Buonomo, Tiziana De Pasquale, Lucilla PascoliniAbstract:Objective: We present the case of a woman with ‘Empty Sella Syndrome’ who experienced generalized urticaria after the administration of sodium succinate hydrocortisone in two episodes. Methods: The patient underwent an allergological evaluation (prick, intradermal, and patch tests) with hydrocortisone sodium succinate, hydrocortisone acetate, hydrocortisone, hydrocortisone sodium phosphate, methylprednisolone hemisuccinate, methylprednisolone, and preservatives held in the formulation of sodium succinate hydrocortisone (sodium phosphate and methyl-p-oxybenzoate). The basophil activation test (BAT) was also performed with hydrocortisone. The single-blind i.m. challenge test was performed with hydrocortisone sodium phosphate in 4 days. Results: Skin test with hydrocortisone sodium succinate and methylprednisolone hemisuccinate was positive. On the contrary, allergological tests performed with other formulations of the same steroids and preservatives were negative. These results showed an immediate-type allergy to succinate ester. BAT was not helpful to improve our diagnostic work-up because our patient was a ‘nonresponder.’ Therefore, the patient underwent successfully to a challenge test with hydrocortisone sodium phosphate. Conclusions: Patients with succinate ester allergy can tolerate alternative corticosteroids without ester.
Patrick J Codd - One of the best experts on this subject based on the ideXlab platform.
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transnasal transsphenoidal elevation of optic chiasm in secondary Empty Sella Syndrome following prolactinoma treatment
World Neurosurgery, 2018Co-Authors: Mary Inping Huang Cobb, Matthew G Crowson, Rachael A Mintzcole, David W Jang, Aatif M Husain, Miles Berger, Patrick J CoddAbstract:Background Prolactinomas are typically treated nonsurgically with a dopamine agonist. Once the tumor shrinks, adjacent eloquent structures, such as the optic apparatus, can become skeletonized and herniate into the dilated paraSellar space. Case Description A 48-year-old man with a prolactin-secreting macroadenoma treated with cabergoline presented with progressive bitemporal hemianopsia. Magnetic resonance imaging showed no recurrence of disease and a stretched optic chiasm herniating into an Empty Sella. Elevation of the optic chiasm via a transnasal transsphenoidal approach with ALLODERM graft and septal cartilage strut was performed. The patient was discharged home the next day with significant improvement in vision; magnetic resonance imaging showed interval elevation of the optic chiasm. Conclusions We review secondary Empty Sella Syndrome and discuss surgical strategies for optic chiasmapexy.
Eleonora Nucera - One of the best experts on this subject based on the ideXlab platform.
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'Empty Sella Syndrome': a case of a patient with sodium succinate hydrocortisone allergy
European Journal of Endocrinology, 2010Co-Authors: Eleonora Nucera, Amira Colagiovanni, Valentina Pecora, Vito Sabato, Angela Rizzi, Arianna Aruanno, C. Lombardo, Alessandro Buonomo, Tiziana De Pasquale, Lucilla PascoliniAbstract:Objective: We present the case of a woman with ‘Empty Sella Syndrome’ who experienced generalized urticaria after the administration of sodium succinate hydrocortisone in two episodes. Methods: The patient underwent an allergological evaluation (prick, intradermal, and patch tests) with hydrocortisone sodium succinate, hydrocortisone acetate, hydrocortisone, hydrocortisone sodium phosphate, methylprednisolone hemisuccinate, methylprednisolone, and preservatives held in the formulation of sodium succinate hydrocortisone (sodium phosphate and methyl-p-oxybenzoate). The basophil activation test (BAT) was also performed with hydrocortisone. The single-blind i.m. challenge test was performed with hydrocortisone sodium phosphate in 4 days. Results: Skin test with hydrocortisone sodium succinate and methylprednisolone hemisuccinate was positive. On the contrary, allergological tests performed with other formulations of the same steroids and preservatives were negative. These results showed an immediate-type allergy to succinate ester. BAT was not helpful to improve our diagnostic work-up because our patient was a ‘nonresponder.’ Therefore, the patient underwent successfully to a challenge test with hydrocortisone sodium phosphate. Conclusions: Patients with succinate ester allergy can tolerate alternative corticosteroids without ester.
Gautam U. Mehta - One of the best experts on this subject based on the ideXlab platform.
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effect of primary Empty Sella Syndrome on pituitary surgery for cushing s disease
Journal of Neurosurgery, 2014Co-Authors: Gautam U. Mehta, Kamran D BakhtianAbstract:Object Primary Empty Sella Syndrome (ESS) results from herniation of arachnoid mater into the pituitary fossa. It has been suggested to have a negative effect on pituitary surgery; however, outcomes in this cohort have not been defined. This study was performed to determine the effect of ESS on immediate and long-term biochemical outcome after pituitary surgery for Cushing's disease (CD). Methods Using a matched cohort study design, the authors followed patients treated with pituitary surgery for CD with and without ESS. Complete ESS was defined as pituitary gland height ≤ 2 mm, whereas partial ESS was defined as pituitary gland height > 2 mm but less than three-quarters of the total Sellar depth. The primary end points were immediate and long-term biochemical outcome. Cerebrospinal fluid leaks were recorded as a secondary end point. Results Seventy-eight patients with CD and primary ESS were identified and matched with 78 patients with CD without ESS. After surgical management, immediate biochemical remi...
Mary Inping Huang Cobb - One of the best experts on this subject based on the ideXlab platform.
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transnasal transsphenoidal elevation of optic chiasm in secondary Empty Sella Syndrome following prolactinoma treatment
World Neurosurgery, 2018Co-Authors: Mary Inping Huang Cobb, Matthew G Crowson, Rachael A Mintzcole, David W Jang, Aatif M Husain, Miles Berger, Patrick J CoddAbstract:Background Prolactinomas are typically treated nonsurgically with a dopamine agonist. Once the tumor shrinks, adjacent eloquent structures, such as the optic apparatus, can become skeletonized and herniate into the dilated paraSellar space. Case Description A 48-year-old man with a prolactin-secreting macroadenoma treated with cabergoline presented with progressive bitemporal hemianopsia. Magnetic resonance imaging showed no recurrence of disease and a stretched optic chiasm herniating into an Empty Sella. Elevation of the optic chiasm via a transnasal transsphenoidal approach with ALLODERM graft and septal cartilage strut was performed. The patient was discharged home the next day with significant improvement in vision; magnetic resonance imaging showed interval elevation of the optic chiasm. Conclusions We review secondary Empty Sella Syndrome and discuss surgical strategies for optic chiasmapexy.