{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T23:14:01Z","timestamp":1790723641611,"version":"4.1.0"},"reference-count":18,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T00:00:00Z","timestamp":1750809600000},"content-version":"vor","delay-in-days":85,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pulm. circ."],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Hypopituitarism has been reported in patients receiving continuous infusions of prostaglandin I2 (PGI2) analogues for pulmonary hypertension (PH). However, these patients' clinical characteristics, treatment, and prognoses remain unclear. This retrospective multicentre study included 22 patients who developed hypopituitarism while on continuous PGI2 analogue infusion between 1999 and 2021. All patients were female, and idiopathic pulmonary arterial hypertension was the most common underlying condition (63.6%). Their mean age was 38.8\u2009\u00b1\u20097.9 years. Epoprostenol was the predominant PGI2 analogue used (90.9%). At the time of hypopituitarism onset, the median PGI2 dose was 67.2\u2009ng\/kg\/min (31.8\u201388.7\u2009ng\/kg\/min), and the median treatment duration was 889.0 days (450.5\u20131941.5 days), suggesting that hypopituitarism occurred independent of its dose or treatment duration. Diagnoses were based on decreased adrenocorticotropic hormone levels. The hypopituitarism classification revealed isolated pituitary dysfunction in 54.5% of the cases, partial dysfunction in 18.1%, and complete dysfunction in 27.2%. Most cases could be managed without requiring specific therapies. After hypopituitarism onset, 63.6% of the patients continued to receive the same PGI2 analogue. Hydrocortisone therapy was administered to 81.8% of the patients, leading to clinical stabilisation. No deaths were reported. In conclusions, hypopituitarism may occur during continuous PGI2 analogue infusion for PH, irrespective of its dose or treatment duration. Initiating hydrocortisone therapy may be important for stabilising the clinical course.<\/jats:p>","DOI":"10.1002\/pul2.70116","type":"journal-article","created":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T13:16:09Z","timestamp":1750857369000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Hypopituitarism Induced by Continuous Infusion of PGI2 Analogues: A Case Series and the Role of ACTH Screening and Hydrocortisone Treatment"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1795-6872","authenticated-orcid":false,"given":"Taijyu","family":"Satoh","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine Tohoku University Graduate School of Medicine Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichi","family":"Tamura","sequence":"additional","affiliation":[{"name":"Pulmonary Hypertension Center International University of Health and Welfare Mita Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriaki","family":"Takama","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Gunma University Graduate School of Medicine Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromi","family":"Matsubara","sequence":"additional","affiliation":[{"name":"Department of Cardiology Okayama Medical Center Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhiro","family":"Tanabe","sequence":"additional","affiliation":[{"name":"Pulmonary Hypertension Center Chibaken Saiseikai Narashino Hospital Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takumi","family":"Inami","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Kyorin University School of Medicine Mitaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8324-0004","authenticated-orcid":false,"given":"Takahiro","family":"Hiraide","sequence":"additional","affiliation":[{"name":"Department of Cardiology Keio University School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohtaro","family":"Abe","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medical Sciences Kyushu University Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Dohi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Kure Kyosai Hospital Kure Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshito","family":"Ogihara","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Nephrology Mie University Graduate School of Medicine Tsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Ogo","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Circulation Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiro","family":"Adachi","sequence":"additional","affiliation":[{"name":"Department of Cardiology Nagoya University Hospital Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiko","family":"Nakazato","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Fukushima Medical University School of Medicine Fukushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ichizo","family":"Tsujino","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Faculty of Medicine Hokkaido University Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideki","family":"Ota","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology Tohoku University Hospital Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohei","family":"Komaru","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Tohoku University Graduate School of Medicine Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruka","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Tohoku University Graduate School of Medicine Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuta","family":"Tezuka","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Metabolism and Endocrinology Tohoku University Hospital Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshikiyo","family":"Ono","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Metabolism and Endocrinology Tohoku University Hospital Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7835-9510","authenticated-orcid":false,"given":"Rika","family":"Suda","sequence":"additional","affiliation":[{"name":"Pulmonary Hypertension Center Chibaken Saiseikai Narashino Hospital Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuya","family":"Hosokawa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medical Sciences Kyushu University Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarasa","family":"Isobe","sequence":"additional","affiliation":[{"name":"Pulmonary Hypertension Center International University of Health and Welfare Mita Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takatoyo","family":"Kiko","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Circulation Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Koga","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine Kurume University School of Medicine Kurume Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junichi","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Faculty of Medicine Hokkaido University Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichiro","family":"Sugimura","sequence":"additional","affiliation":[{"name":"Department of Cardiology International University of Health and Welfare Narita Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaru","family":"Hatano","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medicine The University of Tokyo  Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Fukumoto","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine Kurume University School of Medicine Kurume Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Yasuda","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Tohoku University Graduate School of Medicine Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,25]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac237"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0055-2016"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2023.08.078"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/2045893217719250"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.123.320045"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.12472"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0033518"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00408-019-00283-8"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajpath.2016.08.020"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.176.5.494-a"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.48.3.378"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-66-0158"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1503184"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(03)00463-7"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/pul2.12074"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2008470"},{"key":"e_1_2_13_18_1","first-page":"551","article-title":"MR Height of the Pituitary Gland as a Function of Age and Sex: Especially Physiological Hypertrophy in Adolescence and in Climacterium","volume":"18","author":"Tsunoda A.","year":"1997","journal-title":"American Journal of Neuroradiology"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0887-2171(05)80079-4"}],"container-title":["Pulmonary Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pul2.70116","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:24:12Z","timestamp":1751243052000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pul2.70116"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":18,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1002\/pul2.70116"],"URL":"https:\/\/doi.org\/10.1002\/pul2.70116","archive":["Portico"],"relation":{},"ISSN":["2045-8940","2045-8940"],"issn-type":[{"value":"2045-8940","type":"print"},{"value":"2045-8940","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]},"assertion":[{"value":"2025-02-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70116"}}