A Case with Empty Sella Syndrome Combined with Multiple Anterior Pituitary Hormone Deficiencies Presenting as Hypoglycemic Coma.
10.7180/kmj.2014.29.2.151
- Author:
Soo Kyoung KIM
1
;
Sung Su KIM
;
Bo Ra KIM
;
Jung Hwa JUNG
;
Jae Hoon JUNG
;
Jong Ryeal HAHM
Author Information
1. Department of Internal Medicine, Gyeongsang National University, Jinju, Korea.
- Publication Type:Case Report
- Keywords:
ACTH deficiency;
Empty sella;
Hypoglycemia
- MeSH:
Coma*;
Diabetes Mellitus;
Emergency Service, Hospital;
Empty Sella Syndrome*;
Follicle Stimulating Hormone;
Growth Hormone;
Humans;
Hydrocortisone;
Hypoglycemia;
Hyponatremia;
Hypothyroidism;
Insulin;
Luteinizing Hormone;
Magnetic Resonance Imaging;
Male;
Middle Aged;
Plasma;
Prolactin;
Seizures;
Shock;
Thyrotropin
- From:Kosin Medical Journal
2014;29(2):151-155
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A 55-year-old male was admitted to emergency department with a hypoglycemic shock of unknown origin. He was presented with tonic seizure activity after admission. Initial diagnostic procedure could exclude diabetes mellitus, drug side effects, and exogenous insulin application. Detailed evaluation of the patient's history revealed that the patient had experienced repeated hypoglycemic episodes for 2 years. He was diagnosed with hypothyroidism six years ago. Initial laboratory investigations revealed hypoglycemia, hyponatremia, and low plasma cortisol level (0.18 microg/dL). Sellar magnetic resonance imaging showed empty sella. Replacement therapy with hydrocortisone resulted in the improvement of clinical symptoms. Combined pituitary stimulation test with exception of hypoglycemia induced growth hormone and cortisol stimulation test was performed. The response of thyroid stimulating hormone, prolactin, follicle-stimulating hormone, and luteinizing hormone was normal. We report the case of empty sella syndrome associated with hypoglycemic shock due to with multiple anterior pituitary hormone deficiencies.
