1. A rare case of pituitary apoplexy secondary to dengue haemorrhagic fever.
- Author
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Varma, C. H. Sree Harsha, Reddy, P. Amaresh, Pradeep, T. V. S., and Sree, R. Sindhu
- Subjects
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DENGUE hemorrhagic fever , *CEREBROVASCULAR disease , *GALACTORRHEA - Abstract
Introduction: Pituitary apoplexy is a rare clinical syndrome that occurs as a result of acute haemorrhage and/or infarction within a pituitary tumour. The true incidence of this rare condition is difficult to determine. In a large epidemiological study from the UK, 6.2 Pituitary apoplexy cases/1,00,000 population were identified. Case Report: We present a case of 39 year old female patient who presented to the emergency with acute febrile illness since 8 days, melena since 3 days and sudden onset loss of vision and ptosis in the right eye along with worsening of sensorium. She had history of amenorrhoea since 3 years along with galactorrhoea. She had history of pituitary macroadenoma for which she underwent surgery 8 years back. On examination she was found to have dilated, non reacting pupil with external ophthalmoplegia on the right side. She also had galactorrhea and sparse axillary and pubic hair. Febrile illness work up showed her to have dengue fever (IgM positive) with thrombocytopenia (11,000). Biochemical work up show free T4 -- 0.95 ng/dl and 8 am cortisol -- 120 nmol/L. MRI brain was done and it showed a pituitary adenoma with apoplexy. She was started on inj. Hydrocortisone infusion along with platelet infusions to correct thrombocytopenia. She underwent decompression surgery following which symptoms subsided. Conclusion: Dengue haemorrhagic fever leading to apoplexy in pituitary adenoma is extremely rare with very few cases reported in literature. Pituitary apoplexy should be considered as differential diagnosis in cases of sudden loss of vision with thrombocytopenia. [ABSTRACT FROM AUTHOR]
- Published
- 2017