Modifications of Thermoregulation in Patients With Suprasellar Pituitary Adenomas

Abstract

Thermoregulation was investigated pre and postoperatively in 5 and only preoperatively in 7 patients with suprasellar pituitary adenomas by exposing them to external cold and heat in a climatic chamber. Five healthy subjects served as controls. Body core and skin temperatures, oxygen consumption, electromyographic activity, skin blood flow and local sweating rates were continuously measured. Threshold temperatures for activation of heat production and heat loss were calculated from these data. Hormone analysis was performed before and after stimulation with releasing factors. In the patients, core temperatures as well as threshold temperatures for heat production and heat loss were elevated by about 0.5 degrees C as compared with controls. This elevation of core and threshold temperatures was achieved, despite a reduced resting metabolic rate, by a reduction of skin blood flow indicated by a low mean skin temperature. After successful operation the thermoregulatory alterations normalized. Serum levels of growth hormone were reduced preoperatively and stimulation by GHRF did not cause an appropriate increase. Prolactin was elevated in 6 patients with prolactinomas, but there was no correlation with changes in thermoregulatory threshold temperatures. Stimulation of the other hypophyseal hormones by the combined anterior pituitary function test revealed a normal hormonal response. Apart from prolactin there were no significant hormonal changes postoperatively. It is concluded that disturbances of temperature regulation are present in patients with suprasellar adenomas, but that they are not detectable by routine clinical methods. These alterations probably depend on a disturbance of hypothalamic function and are reversible by surgery.

Comparison of propofol versus sevoflurane on thermoregulation in patients undergoing transsphenoidal pituitary surgery: A preliminary study

“…This could be due to the altered thermoregulation in patients with pituitary tumors as demonstrated by Behr and colleagues. [2] Induction of general anesthesia causes hypothermia in a characteristic pattern, an initial rapid decrease in core temperature, mainly due to internal core to peripheral redistribution of body heat, a slower, linear decrease in core temperature and a core temperature plateau resulting from decreased cutaneous heat loss. [6–8] Almost all anesthetic agents cause a dose-dependent decrease in the thermoregulatory threshold for vasoconstriction, but the exact figure is variable.…”

“…[1] Disturbed thermoregulation has also been reported in patients with pituitary tumors. [2] During surgery of pituitary tumor removal, this thermoregulation is likely to be affected primarily due to the close proximity of hypothalamus. Hypothalamic stimulation may occur due to tumor itself, intraoperative handling/stimulus or anesthetics induced.…”

Early and Longtime Modifications of Temperature Regulation after Severe Head Injury

“…All individuals were exposed to external heat and cold and threshold temperatures for heat production and dissipation were determined by measurement of metabolic rate, electrical muscle activity, local sweat rate and local skin blood flow. For details see Brück, 7 Hessemer, 8 and Behr 9 …”

Fever of unknown origin in the dog

“…Τέλος, ΠΑΠ εν δέχεται να προκαλέσουν η συγγενής αμυλοειδωση των νεφρών (οικογενής αμυλοειδωση των Shar-pei) (DiBartola et al 1990, Rivas et al 1993, τα μεταβολι κά νοσήματα των οστών και ο υπερθυρεοειδισμός (Limn 2001). Στον άνθρωπο ενοχοποιούνται επιπλέ ον τα τραύματα και τα νεοπλάσματα του υποθαλάμου (Clar 1985, Behr et. al.…”