Sheehan’s like syndrome in a man
Autor: | Raya Almazrouei, D Model, Karim Meeran |
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Rok vydání: | 2019 |
Předmět: |
Adenoma
Male Pituitary gland medicine.medical_specialty Antineoplastic Agents Hormonal Hormone Replacement Therapy Prednisolone Infarction Hypopituitarism Medicine General & Internal Pituitary adenoma General & Internal Medicine Internal medicine medicine Humans Pituitary Neoplasms Hormone replacement therapy 11 Medical and Health Sciences Aged 80 and over Pregnancy Science & Technology medicine.diagnostic_test business.industry Magnetic resonance imaging General Medicine medicine.disease Pituitary Hormones Thyroxine medicine.anatomical_structure Endocrinology Hypothalamus Vascular flow Hemianopsia Visual Fields business Life Sciences & Biomedicine |
Zdroj: | QJM: An International Journal of Medicine. 112:811-812 |
ISSN: | 1460-2393 1460-2725 |
Popis: | An 84-year-old physician self-diagnosed that he had a pituitary tumour when he was found to have a bilateral upper quadrantanopia on routine eye testing. Magnetic resonance imaging (MRI) confirmed a large non-functioning pituitary macroadenoma associated with chiasmal compression. Investigation showed partial hypopituitarism with disconnection hyperprolactinaemia [prolactin 1095 mU/L (60–300)]. He was treated with hormonal replacement consisting of thyroxin 100 µg and prednisolone 3 mg and was offered transphenoidal hypophysectomy, but chose a conservative approach. Two years later, his visual fields worsened (Figure 1A) corresponding to an increase in macrodenoma size. Subsequently, he fell and fractured his left shoulder, which became infected, requiring surgery. Immediately after the shoulder surgery, he became hypotensive and vomited several times, and his visual fields became restricted. MRI showed pituitary infarction (Figure 1B), and he did not require surgical intervention. A few weeks later, he noticed dramatic improvement in his vision. His prolactin level dropped from a peak level of 1095 to 48 mU/L (60–300), suggesting lactotroph infarction. Repeated pituitary MRI showed dramatic reduction in the height of the pituitary macroadenoma consistent with the improvement in his visual fields (Figure 1C). |
Databáze: | OpenAIRE |
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