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- Title
A case of pregnancy with pituitary macroadenoma and apoplexy.
- Authors
Sangeetha, S.; Sachan, Alok; Suresh, V.; Kumar, P. Satish; Bitla, Aparna R.; Lakshmi, A. Y.
- Abstract
Introduction:Pregnancy is associated with an increase in size of pituitary gland and preexisting adenomas. Occurrence of new tumors is rare during pregnancy. But macroadenomas can present for the first time during pregnancy and rarely undergo apoplexy with hypopituitarism. Case Report: A 20-year-old antepartum female with 3 months of gestation (G2P1L1) presented with complaints of headache since 1 week, drooping of right upper eyelid, and diplopia since 5 days. Clinical examination revealed decreased visual acuity with normal fundusand right third cranial nerve palsy. Magnetic resonance imaging (MRI) brain showed pituitary macroadenoma with apoplexy. Hormonal evaluation was done. Basal cortisol level was suggestive of adrenal insufficiency. Thyroid profile was suggestive of inappropriately normal thyroid stimulating hormone (TSH) with low levels of triiodothyronine (T3) and thyroxine (T4) for the gestational age. Serum prolactin levels were within normal limits. Patient was started on steroid and thyroxine supplements with stress dose advice for delivery. Patient delivered a healthy male baby by lower segment cesarean section (LSCS). Patient had significant polyuria and polydipsia during follow-up after delivery. Water deprivation test was suggestive of central diabetes insipidus. Patient was started on desmopressin. Repeat MRI pituitary showed empty sella. Conclusion: This case report illustrates that pituitary macroadenomas may rarely present for the first time during pregnancy as apoplexy. The increased size and vascularity of the gland during pregnancy may predispose to apoplexy.
- Subjects
PREGNANCY complications; ADENOMA; TUMORS; CEREBROVASCULAR disease; THYROTROPIN; PROLACTIN
- Publication
Indian Journal of Endocrinology & Metabolism, 2013, Vol 17, Issue S1, pS388
- ISSN
2230-8210
- Publication type
Article