ECE2021 Audio Eposter Presentations Pituitary and Neuroendocrinology (113 abstracts)
Department of Endocrinology and Metabolic Diseases University Hospital Center Ibn Rochd Casablanca, Laboratory of Clinical Neurosciences and Mental Health Faculty of Medicine and Pharmacy Hassan II University, Casablanca, Morocco
Introduction
Apoplexy is a rare, serious and acute complication of pituitary adenomas, revealed by tumor syndrome, visual disturbances and hormonal deficits in 60% of cases. We report a case in which the diagnosis of acromegaly was revealed by pituitary apoplexy.
Observation
45-year-old patient. The examination found a tumor syndrome made up of headaches, reduced visual acuity and vomiting which had evolved for 10 days before admission. The clinical examination reveals a rapid deterioration of the general condition associated with a dysmorphic syndrome evoking acromegaly. The hormonal assessment showed a thyrotropic, corticotropic and hyper-prolactinemia deficit with a level of IGF-1 at 486.6ng/ml (88-140) or 3.47 times the normal and on MRI a sellar process. 32 × 23 × 30mm with hemorrhagic component. The patient underwent a large adenoma excision by the transphenoidal route with simple postoperative consequences. The hormone replacement therapy was: hydrocortisone parenterally and then orally with levothyrox.
Discussion and conclusion
The revelation of acromegaly by pituitary apoplexy is exceptional. Our observation has as a particularity a favorable and rapid evolution of the pituitary apoplexy complicated by anterior pituitary insufficiency after hormonal substitution and simple postoperative consequences.