Pituitary apoplexy secondary to pituitary macroadenoma, a diagnostic challenge

Authors

  • Ángel Sánchez-Tinajero <p>Instituto Nacional de Enfermedades Respiratorias Ismael Cos&iacute;o Villegas, Departamento de Infectolog&iacute;a, Servicio de Microbiolog&iacute;a Cl&iacute;nica. Ciudad de M&eacute;xico</p>
  • Danna Patricia Ruiz-Santillán <p>Instituto Nacional de Cancerolog&iacute;a, Departamento de Patolog&iacute;a, &Aacute;rea de Oncopatolog&iacute;a. Ciudad de M&eacute;xico</p>

Keywords:

Apoplexy, Pituitary, Pituitary Apoplexy, Adenoma

Abstract

Background: Pituitary apoplexy is a clinical syndrome reflecting a rapid expansion of sellar content, typically secondary to a stroke in a previous pituitary adenoma. This pathology is a rare complication, and, therefore, underdiagnosed. The consequences of a delay in the diagnosis are translated into serious functional and even deadly complications for the patient.

Case report: We present the case of a 42-year-old male patient, who began his condition with a diffuse clinical setting, characterized by headache, amblyopia, and alterations of consciousness. The diagnosis was pituitary apoplexy, and secondary hypopituitarism, and it was treated in a conservative way, with steroid anti-inflammatories and hormonal substitution. The patient presented a psychotic episode induced by steroids, due to the supraphysiological doses used, necessary to reverse the existing neurological damage; however, it ended in a restitutio ad integrum 15 days after medical treatment, without requiring neuro-surgical intervention.

Conclusions: The clinical case presented and its resolution are clear evidence of the importance of a timely and adequate diagnosis, given that being detected in early stages, and treated early according to the evolution of the pathology, will not always require surgical intervention, allowing a total neurological restitution.

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Author Biography

  • Ángel Sánchez-Tinajero, <p>Instituto Nacional de Enfermedades Respiratorias Ismael Cos&iacute;o Villegas, Departamento de Infectolog&iacute;a, Servicio de Microbiolog&iacute;a Cl&iacute;nica. Ciudad de M&eacute;xico</p>

    Médico Cirujano- Universidad Nacional Autónoma de México (UNAM)

    Estudiante de Maestría en Ciencias Quimicobiologicas- Instituto Politécnico Nacional (IPN)

    Protocolo de Investigación, Estudiante de posgrado- Instituto Nacional de Enfermedades Respiratorias (INER), departamento de Microbiología clínica.

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Published

2020-04-07

Issue

Vol. 57 No. 4 (2019): July-August

Section

Clinical Cases

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