{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:19:55Z","timestamp":1777879195982,"version":"3.51.4"},"reference-count":34,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Endocrinology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Pituitary apoplexy (PA) is a neuroendocrine emergency characterized by acute hemorrhage or infarction of a pituitary adenoma. While its initial presentation and management are well documented, data on recurrent PA remain scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To determine the prevalence, clinical characteristics, and predictors of recurrent PA in a national cohort, and to contextualize findings through a structured review of the literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Multicenter retrospective cohort study complemented by a structured literature review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We analyzed 274 patients from the Spanish Pituitary Apoplexy Registry (2010\u20132023) with complete follow-up. Recurrent PA was defined as a new acute episode with radiological evidence of hemorrhage or infarction within a previously affected lesion. Clinical, radiological, and treatment-related variables were compared between recurrent and non-recurrent cases. A complementary literature review identified published reports of recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Recurrent PA occurred in 9 patients (3.3%), including 6 of 214 with nonfunctioning adenomas (2.8%) and 3 of 60 with functioning adenomas (5.0%). Compared with nonrecurrent cases, patients with recurrence had significantly larger tumors (median 35 vs 25\u2009mm;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.006), higher rates of cavernous sinus invasion (77.9% vs 37.3%;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.006), and more frequent prior cabergoline therapy (33.3% vs 6.3%;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.020). Median time to recurrence was 18\u2009months (range, 2\u2013108). The literature review identified 11 studies reporting recurrence rates of 2.6%\u201316.7%, with more consistent estimates (4%\u20139.6%) in larger series (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009\u2a7e\u200950). All recurrent cases showed a favorable clinical course and recovery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Recurrent PA is uncommon, affecting approximately 3% of patients with a prior apoplexy episode. Given the low frequency of recurrence, the associated factors identified should be interpreted cautiously and considered primarily hypothesis-generating. The second episode was not more severe than the initial event, and the long-term prognosis was favorable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration:<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20420188261434641","type":"journal-article","created":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T03:33:52Z","timestamp":1774755232000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Recurrent pituitary apoplexy: experience from a national registry and review of the literature"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8837-4343","authenticated-orcid":false,"given":"Betina","family":"Biagetti","sequence":"first","affiliation":[{"name":"Endocrinology and Nutrition Department, Hospital Universitario Vall de Hebr\u00f3n, Universitat Aut\u00f2noma de Barcelona, ENDO-ERN, Pg. de la Vall d\u2019Hebron, 119, Horta-Guinard\u00f3, Barcelona 08035, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esteban","family":"Cordero Asanza","sequence":"additional","affiliation":[{"name":"Neurosurgery Department, Hospital Universitario Vall de Hebr\u00f3n, Universitat Aut\u00f2noma de Barcelona, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Iglesias","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Hospital Universitario Puerta de Hierro Majadahonda, Instituto de Investigaci\u00f3n Sanitaria Puerta de Hierro Segovia de Arana, Majadahonda, Spain"},{"name":"Department of Medicine, Universidad Aut\u00f3noma de Madrid, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosa","family":"Camara","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Service, La Fe University Hospital, Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Queralt","family":"Asla","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department, Hospital de la Santa Creu i Sant Pau, IR-SANTPAU, ENDO-ERN, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Almudena","family":"Vicente","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department, Hospital Universitario de Toledo, Toledo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Martinez-Saez","sequence":"additional","affiliation":[{"name":"Pathology Department, Hospital Universitario Vall de Hebr\u00f3n, Universitat Aut\u00f2noma de Barcelona, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvana","family":"Sarria-Estrada","sequence":"additional","affiliation":[{"name":"Neuroradiology Section, Radiology Department, Vall d\u2019Hebron University Hospital, Vall d\u2019Hebron Barcelona Hospital Campus, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manel","family":"Puig-Domingo","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Service, Germans Trias Hospital and Research Institute, Badalona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Raras U747, Universitat Aut\u00f2noma de Barcelona, Badalona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0519-0072","authenticated-orcid":false,"given":"Marta","family":"Araujo-Castro","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department, Hospital Universitario Ram\u00f3n y Cajal, Colmenar Viejo Street km 9, Madrid 28034, Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica Ram\u00f3n y Cajal, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,3,28]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1210\/er.2015-1042"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13092508"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejendo\/lvaf056"},{"key":"e_1_3_5_5_2","article-title":"A prospective, multicenter, observational study of surgical vs nonsurgical management for pituitary apoplexy","volume":"109","author":"Mamelak AN","year":"2024","unstructured":"Mamelak AN, Little AS, Gardner PA, et al. 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J Neurol Surg B Skull Base 2022; 83: E591\u2013E597.","journal-title":"J Neurol Surg B Skull Base"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-8-200710160-00010"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.3892\/etm.2025.12874"},{"key":"e_1_3_5_19_2","article-title":"A complex case of pituitary apoplexy mimicking a stroke: a case report with a review of the literature","volume":"16","author":"Gaydarski L","year":"2024","unstructured":"Gaydarski L, Popov D, Kolev D, et al. A complex case of pituitary apoplexy mimicking a stroke: a case report with a review of the literature. 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