Primary hypothyroidism and postmenopause as the causes of delayed diagnosis of panhypopituitarism in a patient with nonfunctional pituitary adenoma
https://doi.org/10.14341/probl13128
Abstract
Hypopituitarism is a state of complete or partial deficiency of pituitary hormones, including adrenal insufficiency, hypothyroidism, hypogonadism, growth hormone deficiency, and, rarely, diabetes insipidus.
The article describes a clinical case of hypopituitarism due to a pituitary tumor in a postmenopausal woman. Difficulties in diagnosing hypopituitarism were due to a history of primary hypothyroidism. The first identified component of panhypopituitarism in the patient, (central hypothyroidism) had previously been seen as laboratory indications of medication-induced hyperthyroidism.
The non-specific nature of the clinical symptoms, as well as a relatively rare combination of endocrine diseases, led to a long examination period and delayed diagnosis of the pituitary tumor.
Whether the development of hypopituitarism in a patient with a nonfunctional pituitary tumor is an indication for transsphenoidal pituitary surgery remains a controversial issue. The decision for surgery is made taking into account the characteristics of the course of the disease in a particular patient. In this clinical case, a conservative tactic was chosen with hormone replacement therapy for glucocorticoid and thyroid deficiency.
About the Authors
E. G. Ryzhkova
Central Clinical Hospital of the Management Affair of President Russian Federation
Russian Federation
Competing Interests:
Russian Federation
Ekaterina G. Ryzhkova - MD.
15 Marshal Tymoshenko street, Moscow,121359.
SPIN-код: 1903-2007
Competing Interests:
None
D. O. Ladygina
Central Clinical Hospital of the Management Affair of President Russian Federation; Fomin Women’s Health Clinic
Russian Federation
Competing Interests:
Russian Federation
Daria O. Ladygina - MD, PhD.
Moscow.
SPIN-код: 7958-9435
Competing Interests:
None
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1. Figure 1. MRI from 2019: a) T2-WI, sagittal section; b) T1-WI, coronal section. MRI from 2021: c) T2 FLAIR-VI, sagittal section; d) T1-WI, coronal section | |
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For citations:
Ryzhkova E.G., Ladygina D.O. Primary hypothyroidism and postmenopause as the causes of delayed diagnosis of panhypopituitarism in a patient with nonfunctional pituitary adenoma. Problems of Endocrinology. 2022;68(5):32-38. (In Russ.) https://doi.org/10.14341/probl13128
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