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Panhypopituitarism

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https://www.readbyqxmd.com/read/28710301/pituitary-apoplexy-a-rare-complication-of-leuprolide-therapy-in-prostate-cancer-treatment
#1
Georges Tanios, Nicolas Andrews Mungo, Aaysha Kapila, Kailash Bajaj
Gonadotropin-releasing hormone agonists, used widely in the treatment of metastatic prostate cancer and hormone receptor-positive breast cancer, are associated with a rare but potentially fatal outcome of pituitary apoplexy (PA). An 85-year-old man presented with sudden onset of headache, left eye pain, sensitivity to light, nausea and vomiting. The symptoms started 4 hours after initiation of leuprolide therapy for treatment of recently diagnosed metastatic prostate carcinoma. Radiological imaging of the brain demonstrated a heterogeneously enlarged pituitary gland measuring 19×16×13 mm and T1-hyperintense signal compatible with pituitary haemorrhage...
July 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28671425/slipped-capital-femoral-epiphysis-diagnosis-and-management
#2
David M Peck, Lisa M Voss, Tyler T Voss
Slipped capital femoral epiphysis (SCFE) is the most common hip disorder in adolescents, occurring in 10.8 per 100,000 children. SCFE usually occurs in those eight to 15 years of age and is one of the most commonly missed diagnoses in children. SCFE is classified as stable or unstable based on the stability of the physis. It is associated with obesity, growth spurts, and (occasionally) endocrine abnormalities such as hypothyroidism, growth hormone supplementation, hypogonadism, and panhypopituitarism. Patients with SCFE usually present with limping and poorly localized pain in the hip, groin, thigh, or knee...
June 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28626085/diabetes-insipidus-is-an-unfavorable-prognostic-factor-for-response-to-glucocorticoids-in-patients-with-autoimmune-hypophysitis
#3
Isabella Lupi, Mirco Cosottini, Patrizio Caturegli, Luca Manetti, Claudio Urbani, Daniele Cappellani, Ilaria Scattina, Enio Martino, Claudio Marcocci, Fausto Bogazzi
INTRODUCTION: Autoimmune hypophysitis (AH) has a variable clinical presentation and natural history; likewise, its response to glucocorticoid therapy is often unpredictable. OBJECTIVE: To identify clinical and radiological findings associated with response to glucocorticoids. DESIGN AND METHODS: 12 consecutive patients with AH, evaluated from 2008 to 2016. AH was the exclusion diagnosis after ruling out other pituitary masses and secondary causes of hypophysitis...
August 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28625907/long-standing-isolated-autoimmune-hypothalamitis-diagnosed-with-endoscopic-transventricular-biopsy-a-case-report
#4
Lorenzo Bertulli, Giulio Andrea Bertani, Umberto Gianelli, Giovanna Mantovani, Paolo Maria Rampini, Marco Locatelli
BACKGROUND: Autoimmune hypothalamitis, which is among the causes of acquired central diabetes insipidus, has been described very rarely in the literature. This condition is probably provoked by the production of anti-vasopressin secreting cells antibodies and anti-hypothalamus antibodies, and is often associated with pituitary or polyendocrine autoimmunity. Correct diagnosis and immediate treatment are essential in order to avoid the progression of the pathological process. CASE DESCRIPTION: A woman diagnosed with central diabetes insipidus 12 year ago, suffering from panhypopituitarism and mild memory deficit came to our attention...
June 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28615049/a-case-of-acute-sheehan-s-syndrome-and-literature-review-a-rare-but-life-threatening-complication-of-postpartum-hemorrhage
#5
Shinya Matsuzaki, Masayuki Endo, Yutaka Ueda, Kazuya Mimura, Aiko Kakigano, Tomomi Egawa-Takata, Keiichi Kumasawa, Kiyoshi Yoshino, Tadashi Kimura
BACKGROUND: Sheehan's syndrome occurs because of severe postpartum hemorrhage causing ischemic pituitary necrosis. Sheehan's syndrome is a well-known condition that is generally diagnosed several years postpartum. However, acute Sheehan's syndrome is rare, and clinicians have little exposure to it. It can be life-threatening. There have been no reviews of acute Sheehan's syndrome and no reports of successful pregnancies after acute Sheehan's syndrome. We present such a case, and to understand this rare condition, we have reviewed and discussed the literature pertaining to it...
June 14, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28593907/opioid-induced-hyponatremia-in-a-patient-with-central-diabetes-insipidus-independence-from-adh
#6
Nandini Bhat, Erjola Balliu, Jennifer Osipoff, Andrew Lane, Thomas Wilson
Hyponatremia can be a complication of opioid therapy, which has been postulated to occur secondary to inappropriate antidiuretic hormone secretion (syndrome of inappropriate antidiuretic hormone secretion [SIADH]). We report severe hyponatremia following wisdom teeth extraction with opioid analgesia in a 19-year-old female with diabetes insipidus (DI) and acquired panhypopituitarism that challenges this theory. As this patient has DI, we believe opioid treatment caused severe hyponatremia by the following mechanisms: (1) Opioids have a direct antidiuretic effect independent of changes in ADH, as demonstrated in Brattleboro rats with central DI...
May 24, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28567321/neuropsychiatric-manifestations-in-a-patient-with-panhypopituitarism
#7
Oluwole Jegede, Ajouka Jeyakumar, Thyarapan Balakumar, Alyssa Raghu, Katherine I Chang, Katarina Soewono, Mario Gustave, Ayodeji Jolayemi
We present a case of an incidental diagnosis of panhypopituitarism in a 68-year-old African American man admitted to our psychiatric inpatient unit with symptoms suggestive of schizophrenia. The case was unusual as a first-episode psychosis given the patient's age. In the course of his admission, the patient's clinical condition deteriorated culminating in a sudden altered mental status which prompted a transfer to the medical floors and further investigations. A head CT scan and a pituitary MRI revealed a near total resection of the pituitary while laboratory investigations revealed hyponatremia and a grossly low hormone profile...
2017: Case Reports in Psychiatry
https://www.readbyqxmd.com/read/28567314/subacute-hypophysitis-with-panhypopituitarism-as-first-presentation-of-hiv-and-syphilis-coinfection
#8
Rute Alves, Margarida França
Infection by Treponema pallidum still represents a clinical challenge due to its various forms of presentation. HIV coinfection added diversity and changed the natural history of syphilis as a systemic infection. We present a rare case of subacute hypophysitis and panhypopituitarism due to an early active neurosyphilis in a previously unknown HIV coinfected patient.
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28562421/ventricular-fibrillation-and-long-qt-syndrome-due-to-panhypopituitarism
#9
Milena Aste, Cesare Capellini, Elisabetta Schiappacasse, Gianluigi Devoto, Michele Brignole
: A 68-year-old man presented with ventricular fibrillation and acquired long QT due to panhypopituitarism that disappeared completely within 48 h from replacement hormonal therapy. Panhypopituitarism is not well recognized as a reversible cause of ventricular fibrillation and long-QT syndrome in medical literature. In the present case, pituitary apoplexy exhausted an already chronically hypofunctioning pituitary gland, causing QT prolongation, torsades de pointes and several cardiac arrests due to ventricular fibrillation...
May 29, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28552871/a-case-of-stiff-person-syndrome-due-to-secondary-adrenal-insufficiency
#10
Yuri Mizuno, Hiroo Yamaguchi, Taira Uehara, Kenichiro Yamashita, Ryo Yamasaki, Jun-Ichi Kira
We report a case of flexion contractures in a patient's legs secondary to postpartum hypopituitarism. A 56-year-old woman presented with a 3-year history of worsening flexion contractures of the hips and knees. On admission, her hips and knees could not be extended, and she had muscle stiffness and tenderness to palpation of the lower extremities. We first suspected stiff-person syndrome or Isaacs' syndrome because of her muscle stiffness. However, multiple hormones did not respond to stimulation tests, and an MRI of the brain showed atrophy of the pituitary gland with an empty sella...
May 26, 2017: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/28551652/successful-treatment-of-pituitary-germinoma-with-etoposide-cisplatin-vincristine-methotrexate-and-bleomycin-chemotherapy-without-radiotherapy
#11
Amina Scherz, Katrin Feller, Sabina Berezowska, Vera Genitsch, Martin Zweifel
We report on the case of a 25-year-old man with pituitary germinoma. The patient had noticed polydipsia, reduced sexual function, and loss of body hair. Laboratory investigations confirmed panhypopituitarism including diabetes insipidus. Magnetic resonance imaging of the brain showed a 14×8.4 mm enhancing lesion of the pituitary stalk and histopathology of the neurosurgical biopsy confirmed pituitary germinoma. The patient was treated with 3 cycles of chemotherapy, consisting of 150 mg/m(2) etoposide and 75 mg/m(2) cisplatin, with the administration of intrathecal 12...
June 2017: Anticancer Research
https://www.readbyqxmd.com/read/28527171/lymphocytic-hypophysitis-mimicking-pituitary-macroadenoma
#12
Tarun Kumar Ralot, Jitesh Aggarwal, Raghavendra Haniadka, Kushal Gehlot, Nikhil Dongre, Swapnil Patil
Lymphocytic hypophysitis is an inflammatory /autoimmune disorder that primarily involves the pituitary gland and the pituitary stalk. The common clinical presentations include headache, nausea, vomiting, fatigue, features of hypopituitarism and diabetes insipidus as well as diplopia, orbital pain and bitemporal hemianopia. We report a case of lymphocytic hypophysitis which presented as hemichorea. Neuroimaging showed a mass in the sella tursica region which, on histopathological examination was suggestive of lymphocytic hypophysitis...
April 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28493439/very-late-presentation-of-a-disorder-of-sex-development
#13
J M Martins, M Fraga, J Miguens, F Tortosa, B Marques, A D Sousa
Disorders of sex development generally present in the neonatal period with ambiguity of external genitalia. We report a very old male patient presenting at 75 years because of panhypopituitarism and a large nonsecreting pituitary macroadenoma secondary to long-standing primary hypogonadism due to 46,XX sex reversal disorder now first diagnosed. Sex development disorders may go unrecognised for the entire life span, despite infertility and long-standing primary gonadic failure may lead to uncommon complications...
May 11, 2017: Andrologia
https://www.readbyqxmd.com/read/28491316/pituitary-abscess-in-an-hiv-1-infected-patient
#14
Hiroyuki Yamazaki, Masayuki Kobayashi, Anamaria Daniela Sarca, Akifumi Takaori-Kondo
OBJECTIVES: Pituitary abscess is a rare occurrence among pituitary conditions, but one which carries life-threatening potential. An immunocompromised status is a risk factor for the development of a pituitary abscess; however, literature describes only one case among HIV-infected patients. METHODS AND RESULTS: We present here a case of pituitary abscess in an HIV-1-positive patient, who demonstrated a shock status, disturbance of consciousness and generalized skin rash with laboratory findings of hypovolemia, acute inflammatory reaction and blood electrolyte abnormality...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28458894/prop1-gene-mutations-in-a-36-year-old-female-presenting-with-psychosis
#15
Durgesh Prasad Chaudhary, Tshristi Rijal, Kunal Kishor Jha, Harpreet Saluja
SUMMARY: Combined pituitary hormonal deficiency (CPHD) is a rare disease that results from mutations in genes coding for transcription factors that regulate the differentiation of pituitary cells. PROP1 gene mutations are one of the etiological diagnoses of congenital panhypopituitarism, however symptoms vary depending on phenotypic expression. We present a case of psychosis in a 36-year-old female with congenital panhypopituitarism who presented with paranoia, flat affect and ideas of reference without a delirious mental state, which resolved with hormone replacement and antipsychotics...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28445302/cholestasis-caused-by-panhypopituitarism-and-acquired-cytomegalovirus-infection-in-a-2-month-old-male-infant-a-case-report
#16
U Chan, Wai-Tao Chan, Wei-Hsin Ting, Che-Sheng Ho, Hsi-Che Liu, Hung-Chang Lee
RATIONALE: Septo-optic dysplasia (SOD) is a rare congenital disorder that may cause jaundice in infants. However, it is usually prone to neglect and misdiagnosis in infants with cholestasis because endocrine disorder such as panhypopituitarism is rare in the cause of infantile cholestasis. We report a case of SOD concurrent with acquired cytomegalovirus (CMV) infection, who presented with prolonged jaundice as the first clinical sign. PATIENT CONCERNS: The patient was a 2-month-old male infant who presented with cholestasis, combined with fever and panhypopituitarism...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28437813/presenting-symptoms-of-pituitary-apoplexy
#17
Efstratios-Stylianos Pyrgelis, Ioannis Mavridis, Maria Meliou
The classical term "pituitary apoplexy" (PA) describes a clinical syndrome usually characterized by abrupt onset of headache accompanied by neurologic and/or endocrinologic deterioration due to sudden expansion of a mass within the sella turcica as a result of hemorrhage or infarction within a pituitary tumor and adjacent pituitary gland. PA is a medical emergency and a difficult diagnosis to establish. Thus this article reviews the presenting symptoms of PA patients to help clinicians recognize or at least suspect this critical condition early on...
April 24, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28425764/braf-v600e-mutant-papillary-craniopharyngioma-dramatically-responds-to-combination-braf-and-mek-inhibitors
#18
Ashley Roque, Yazmin Odia
We present a patient with BRAF-V600E mutant papillary craniopharyngioma successfully treated with combination BRAF (dabrafenib 150 mg twice daily) and MEK (trametinib 2 mg daily) inhibitors after her unresectable tumor proved refractory to radiation. Serial brain MRIs and PET revealed marked tumor reduction with gradual neurological improvement and permanent panhypopituitarism.
April 2017: CNS Oncology
https://www.readbyqxmd.com/read/28325825/very-long-term-sequelae-of-craniopharyngioma
#19
Mark Wijnen, Marry M van den Heuvel-Eibrink, Joseph A M J L Janssen, Coriene E Catsman-Berrevoets, Erna M C Michiels, Marie-Lise C van Veelen-Vincent, Alof H G Dallenga, J Herbert van den Berge, Carolien M van Rij, Aart-Jan van der Lely, Sebastian J C M M Neggers
OBJECTIVE: Studies investigating long-term health conditions in patients with craniopharyngioma are limited by short follow-up durations and generally do not compare long-term health effects according to initial craniopharyngioma treatment approach. In addition, studies comparing long-term health conditions between patients with childhood- and adult-onset craniopharyngioma report conflicting results. The objective of this study was to analyse a full spectrum of long-term health effects in patients with craniopharyngioma according to initial treatment approach and age group at craniopharyngioma presentation...
June 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28318194/-craniopharyngioma-and-klinefelter-syndrome-during-the-pubertal-transition-a-diagnostic-challenge
#20
Yamile Mocarbel, Graciela Arébalo de Cross, Marie C Lebrethon, Albert Thiry, Albert Beckersd, Hernan Valdes-Socin
Craniopharyngioma is the most common pituitary tumor in childhood. It can compromise the pubertal development because of its evolution or treatment. Syndrome of Klinefelter is the most common cause of hipergonadotrophic hypogonadism in males. The concomitant presentation of both entities is extremely low (1/109) and the pathophysiological association is questionned. We present the case of a 18-year-old Belgian patient. He had a diagnosis of craniopharyngioma in childhood and he presented with panhypopituitarism after radiotherapy and surgical treatment...
April 1, 2017: Archivos Argentinos de Pediatría
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