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Dengue hemorrhagic fever: a condition associated with multiple risk factors for pituitary apoplexy.
MedLine Citation:
PMID:  22297060     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objectives: to describe two patients who developed pituitary apoplexy during the course of dengue hemorrhagic fever (DHF).Methods: case report.Results: the first case was a 40-year-old male who developed clinical signs and symptoms of dengue, which was confirmed by serologic exam. He presented with thrombocytopenia and developed severe headache and vomiting. During hospitalization, the diagnosis of acromegaly was suspected due to the characteristic disease phenotype and a magnetic resonance imaging (MRI) was performed, confirming the diagnosis of pituitary apoplexy. Subsequently, the biochemical diagnosis of acromegaly was confirmed and patient was submitted to transphenoidal surgery. Histopathology showed signs of recent bleeding. The other case was a male patient with a macroprolactinoma, being treated with cabergoline for 10 weeks, with laboratorial and imaging improvement. The patient presented then with clinical symptoms of dengue, confirmed by serology, and thrombocytopenia. Afterwards, he developed bilateral hemianopsia and a MRI showed enlargement of the pituitary adenoma with signs of intratumoral bleeding. The patient underwent transsphenoidal surgery and histopathology evidenced a pituitary adenoma diffusely infiltrated by blood cells.Conclusion: we describe dengue as a probable novel condition for pituitary apoplexy because it may be associated with multiple risk factors for pituitary infarction or bleeding. Thus, physicians should be suspicious of pituitary apoplexy in a patient with DHF who develops a rapid onset of severe headache and visual defects, even in patients with undiagnosed pituitary adenomas.
Authors:
Luiz Eduardo Armondi Wildemberg; Leonardo Vieira Neto; Paulo Niemeyer; Emerson L Gasparetto; Leila Chimelli; Mônica Roberto Gadelha
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-31
Journal Detail:
Title:  Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists     Volume:  -     ISSN:  1934-2403     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-2-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9607439     Medline TA:  Endocr Pract     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-17     Citation Subset:  -    
Affiliation:
Endocrinology Section, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Brazil.
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