Document Detail


A case of hypothalamic panhypopituitarism with empty sella syndrome: case report and review of the literature.
MedLine Citation:
PMID:  19352054     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Empty sella syndrome is frequently accompanied with pituitary dysfunction. Most of the patients with empty sella syndrome demonstrate primary pituitary or stalk dysfunction and few cases show hypothalamic dysfunction. A 71-year-old man manifested appetite loss, nausea and vomiting with hyponatremia and adrenal insufficiency. Hormonal evaluation and cranial MRI revealed a panhypopituitarism with empty sella. Intriguingly, while the response of ACTH to CRH administration was exaggerated, the response to insulin hypoglycemia was blunted. Serum PRL levels were normal. Further, decreased level of fT4, slightly elevated basal levels of TSH, and delayed response of TSH to TRH administration were observed. These findings strongly suggest that the panhypopituitarism is caused by hypothalamic dysfunction. The presence of autoantibodies to pituitary and cerebrum in the patient's serum implies an autoimmune mechanism as a pathogenesis.
Authors:
Hisako Komada; Masaaki Yamamoto; Saki Okubo; Kanto Nagai; Keiji Iida; Takehiro Nakamura; Yushi Hirota; Kazuhiko Sakaguchi; Masato Kasuga; Yutaka Takahashi
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Publication Detail:
Type:  Case Reports; Journal Article; Review     Date:  2009-04-07
Journal Detail:
Title:  Endocrine journal     Volume:  56     ISSN:  1348-4540     ISO Abbreviation:  Endocr. J.     Publication Date:  2009  
Date Detail:
Created Date:  2009-07-31     Completed Date:  2009-10-26     Revised Date:  2011-06-16    
Medline Journal Info:
Nlm Unique ID:  9313485     Medline TA:  Endocr J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  585-9     Citation Subset:  IM    
Affiliation:
Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, Kobe University Graduate school of Medicine, Kobe, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Empty Sella Syndrome / etiology*
Encephalitis, Herpes Simplex / complications
Humans
Hypopituitarism / complications*
Hypothalamus / physiopathology
Male
Thyrotropin-Releasing Hormone / diagnostic use
Chemical
Reg. No./Substance:
24305-27-9/Thyrotropin-Releasing Hormone

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


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