Hypopituitarism Presenting as Adrenal Insufficiency and Hypothyroidism in a Patient with Wilson's Disease: a Case Report.
10.3346/jkms.2016.31.8.1345
- Author:
Hae Won LEE
1
;
Jin Du KANG
;
Chang Woo YEO
;
Sung Woon YOON
;
Kwang Jae LEE
;
Mun Ki CHOI
Author Information
1. Department of Internal Medicine, Daedong Hospital, Busan, Korea.
- Publication Type:Case Reports
- Keywords:
Hepatolenticular Degeneration;
Hypopituitarism;
Hypothyroidism;
Adrenal Insufficiency
- MeSH:
Adrenal Insufficiency/diagnosis/etiology;
Adult;
Brain/diagnostic imaging;
Depression/etiology;
Female;
Hepatolenticular Degeneration/*complications;
Humans;
Hypopituitarism/complications/*diagnosis/drug therapy;
Hypothyroidism/diagnosis/etiology;
Liver Cirrhosis/complications/diagnostic imaging;
Magnetic Resonance Imaging;
Steroids/therapeutic use;
Thyrotropin-Releasing Hormone/therapeutic use
- From:Journal of Korean Medical Science
2016;31(8):1345-1348
- CountryRepublic of Korea
- Language:English
-
Abstract:
Wilson's disease typically presents symptoms associated with liver damage or neuropsychiatric disturbances, while endocrinologic abnormalities are rare. We report an unprecedented case of hypopituitarism in a patient with Wilson's disease. A 40-year-old woman presented with depression, general weakness and anorexia. Laboratory tests and imaging studies were compatible with liver cirrhosis due to Wilson's disease. Basal hormone levels and pituitary function tests indicated secondary hypothyroidism and adrenal insufficiency due to hypopituitarism. Brain MRI showed T2 hyperintense signals in both basal ganglia and midbrain but the pituitary imaging was normal. She is currently receiving chelation therapy along with thyroid hormone and steroid replacement. There may be a relationship between Wilson's disease and hypopituitarism. Copper deposition or secondary neuronal damage in the pituitary may be a possible explanation for this theory.
