Endocrine Abstracts

Introduction: Central hyperthermia is frequent in patients with brain injury and is characterized by a rapid onset with high temperatures, marked temperature fluctuations and poor response to antipyretics. It is associated with worse outcomes in the injured brain, thus it is important to aggressively manage it.

Case-report: We report a case of a 9-year-old boy diagnosed with sellar and suprasellar adamantimomatous craniopharyngioma at the age of 5 when he underwent quasitotal resection. After neurosurgery he developed panhypopituitarism and he received replacement hormonal therapy. Notably, the growth rate was one over expectations of about 7 cm/year despite the somatotropic pituitary insufficiency. The evolution was favorable for 4 years when the MRI scan detects tumor recurrence in the third ventricle that required neurosurgery. He was admitted to the Iaşi Endocrinology Department following the quasitotal resection of the recurrent craniopharyngioma. During his admission he developed intractable fever which persisted despite antipyretics. A complete fever workup was performed, but no definite infection source was found. Central fever was a result of damage or dysfunction to central fever control centers, such as at the level of the diencephalon. Bromocriptine was started resulting in control of central hyperthermia. A week later the fever did not exceed 38°C and the month following the treatment the body temperature baseline was reduced to 37°C.

Conclusions: We reported a case of prolonged central fever after neurosurgery of a recurrent craniopharyngioma in a child who was successfully treated with bromocriptine. Althought he developed panhypopituitarism after neurosurgery, he associated normal growth rates and growth hormone therapy was not need.

Keywords: bromocriptine, central hyperthermia, craniopharyngioma.