Endocrine Abstracts

Introduction

SARS-CoV-2 is a novel coronavirus rapidly spread throughout the world.. As it is already known, several endocrine organs do express ACE2, namely, pancreas, thyroid, testis, ovary, adrenal glands, and pituitary We report a patient diagnosed with pituitary incidentaloma and Covid-19. We would like to introduce our experience in treating patient with pituitary incidentaloma and covid-19.

Materials and methods

A 71-yowoman with a history of pituitary macroadenoma was admitted to Heraci University hospital with bilateral pneumonia related to coronaviral infection. According to the patient at the age of 43 after the second delivery (she had 2 pregnancies, 2 deliveries) an olfactory disorder was developed and then 2 years later she was treated by neurologists for trigeminities for many years. In March 2020 she had severe headaches, abrupt deterioration of vision, diplopia, . Brain MRI was performed and it revealed pituitarycystic macroadenoma with compression of chiasmus opticus, spread to cavernous sinuses. Lab results revealed TSH = 10.05 µIU/ml (n 0.27–4.2), FT4 = 0.780 ng/dl (n 0.93–1.7), level of cortisol, ACTH, prolactin were in normal laboratory ranges, as well as HbA1C, glucose and blood electrolites, Pituitary macroadenoma (incidentaloma) and primary hypothyroidism were diagnosed and l-thyroxin 50 mkg together with cabergolin 0.5 mg twice a week (before surgery) were prescribed. In October 2020 patient had following complaints- high temperature, general weakness, shortness of breath. SARS COV-2 PCR test positive. She got treatment at home by GP -Levofloxacin 500 mg 7 days, Dexamethasone 6 mg 4 days, Enoxaparin, Ibuprofen. She was admitted to the hospital on the 12th day of the illness with BMI = 25.3, SpO2 85%(O2-), 96%(O2 +), BP = 120/80 mmHg, Ps = 85 bpm, T = 38.5°C. Chest CT-bilateral pneumonia with a typical viral etiology, mild lesions up to 15%.

Treatment underwent – infusion therapy, Dexamethasone 12 mg with dose decrease to 4 mg, Heparin 10000 U daily, Aspirin, Quamatel, Spironolactone, Galvus 50 mg, l-thyroxin 50 mkg, Oxigen

Results.

The patient improved on treatment. She has no temperature since the 2nd day. Saturation without oxygen was 90% from the 6th day. The patient was advised to continue l-thyroxine therapy with the same dose, remove cabergoline and check prolactin in 6 weeks. Monitoring of glucose level was recommended. After stabilization, surgical treatment of macroadenoma is recommended.