Pituitary apoplexy (PA) is a clinical emergency arising from acute ischemia or hemorrhage of the pituitary gland. A small subset of pituitary adenomas present with an apoplectic crisis, with common symptoms being headache, nausea-vomiting, visual impairment, ophthalmoplegia, altered sensorium, and panhypopituitarism. Though diabetic ketoacidosis (DKA) is an established complication of uncontrolled diabetes mellitus, its association with PA is extremely rare. Likewise, supraventricular tachycardia (SVT) and Acute limb ischemia (ALI) have rare, reported association with DKA. We present one such case of rare associations seen in our clinical practice. A 20-year-old woman was brought to our emergency room with headache, breathlessness, and altered sensorium. Clinical and biochemical evaluation revealed SVT, DKA, and right lower limb ALI. On enquiry, the patient was found to be diagnosed with pituitary adenoma 2 years ago and lost to follow-up. PA was detected on neuroimaging and confirmed histopathologically. Possibility of PA presenting as DKA and its sequelae exists.
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http://dx.doi.org/10.4103/ajns.ajns_217_21 | DOI Listing |
Eur J Case Rep Intern Med
December 2024
Critical Care, Intensive Care Unit, Centro Hospitalar Universitário de Santo António, Porto, Portugal.
Unlabelled: Haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome is a poorly understood, life-threatening multisystemic condition related to pregnancy with a rapid onset, typically observed in patients with severe pre-eclampsia. Various mechanisms may lead to diffuse endothelial damage associated with HELLP and possible brain involvement. A comprehensive review of PubMed, Embase and Cochrane databases was conducted to examine the clinical, laboratory and radiological features associated with postpartum HELLP syndrome, particularly its potential association with posterior reversible encephalopathy syndrome (PRES).
View Article and Find Full Text PDFCureus
December 2024
Department of Neurosurgery, NMC Royal Hospital, Abu Dhabi, ARE.
Patients presenting with acute onset of headache and ophthalmoplegia are clinically diagnosed as having a pituitary adenoma with apoplexy. Rarely, other diseases can mimic this condition clinically and radiologically, requiring a high index of suspicion to reach the correct diagnosis. We present a case of a 37-year-old male of Indian origin, who had intra- and supra-sellar tuberculosis (TB), presenting with classical clinical features of pituitary apoplexy and constitutional symptoms.
View Article and Find Full Text PDFSurg Neurol Int
December 2024
Department of Neurosurgery Westchester Medical Center, Valhalla, New York, United States.
Background: Pituitary apoplexy (PA) is a rare, life-threatening clinical syndrome that occurs in response to acute ischemic infarction or hemorrhage of a pituitary adenoma. We report two cases of sudden neurologic and visual decline in patients with pituitary region masses in coronavirus disease (COVID)-positive patients with a focus on potential pathophysiological mechanisms and a safe approach to treatment.
Case Description: Case one is a 58-year-old male presenting with sudden-onset headache and visual disturbance.
Pituitary
December 2024
Department of Diabetes and Endocrinology, St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia.
Purpose: Rathke's cleft cysts (RCC) are present in up to 20% of autopsy studies but only a minority necessitate surgical treatment. Inflammation of RCC is thought to be significant in three processes: the development of classical symptoms, a predisposition to rupture or apoplexy, and increasing the rate of RCC recurrence. We aim to characterize clinical presentation, histological and radiological findings in patients with surgically managed RCC.
View Article and Find Full Text PDFFront Endocrinol (Lausanne)
December 2024
Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, China.
Background: Pituitary adenomas (PAs) present with clinical features such as neuroendocrine abnormalities and mass effects, common in the general morbidity population. However, in elderly patients, the disease progression renders some clinical features difficult to detect and identify in time. Consequently, elderly patients with PAs are often not identified and receive sufficient intervention on time to achieve a satisfactory outcome.
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