| Pituitary infarction resulting from intranasal cocaine abuse. | |
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MedLine Citation:
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PMID: 16033719 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Jonathan R Insel; Nimrita Dhanjal |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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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:
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Created Date: 2005-07-21 Completed Date: 2005-08-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9607439 Medline TA: Endocr Pract Country: United States |
Other Details:
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Languages: eng Pagination: 478-82 Citation Subset: IM |
Affiliation:
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Arizona Community Physicians, Tucson, 85715, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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