Document Detail


Pituitary infarction resulting from intranasal cocaine abuse.
MedLine Citation:
PMID:  16033719     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To report a case of pituitary infarction attributable to long-term intranasal cocaine use. METHODS: We present the clinical findings, laboratory results, and imaging studies in a woman with hypopituitarism, diabetes insipidus, and a palsy of cranial nerve VI, associated with cocaine-induced destruction of her nasal and paranasal structures and the anterior base of her skull. RESULTS: A 55-year-old woman, a long-term cocaine abuser, presented with delirium, nausea, vomiting, hypoglycemia, hypercalcemia, and hypotension as manifestations of adrenal insufficiency (cortisol levels <1 mg/dL before and after administration of cosyntropin). She was found to have a deficiency of adrenocorticotropic hormone (<1 pg/mL), gonadotropin deficiency (estradiol <20 pg/mL, luteinizing hormone 1.7 mIU/mL, and follicle-stimulating hormone 4.9 mIU/mL), and diabetes insipidus. She also had a palsy of right cranial nerve VI. Computed tomography and magnetic resonance imaging of the head demonstrated extensive destruction of the paranasal sinuses, extending into the base of the skull. Serial magnetic resonance images showed reduction of pituitary volume. Nasal biopsy specimens disclosed findings consistent with cocaine-induced ischemic necrosis. CONCLUSION: To our knowledge, this is the first case of hypopituitarism and diabetes insipidus due to prolonged intranasal cocaine abuse.
Authors:
Jonathan R Insel; Nimrita Dhanjal
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists     Volume:  10     ISSN:  1530-891X     ISO Abbreviation:  Endocr Pract     Publication Date:    2004 Nov-Dec
Date Detail:
Created Date:  2005-07-21     Completed Date:  2005-08-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9607439     Medline TA:  Endocr Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  478-82     Citation Subset:  IM    
Affiliation:
Arizona Community Physicians, Tucson, 85715, USA.
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MeSH Terms
Descriptor/Qualifier:
Administration, Intranasal
Cocaine-Related Disorders / complications*
Diabetes Insipidus, Neurogenic / etiology,  pathology
Female
Humans
Hypopituitarism / etiology*,  pathology*
Infarction / etiology*,  pathology*
Magnetic Resonance Imaging
Middle Aged
Nasal Septum / pathology
Paranasal Sinus Diseases / etiology,  pathology
Pituitary Gland / pathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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