scholarly journals Empty Sella Turcica Syndrome: About a Case Revealed by Adrenal Insufficiency

2021 ◽  
Vol 11 (02) ◽  
pp. 68-72
Author(s):  
Sow Maïmouna ◽  
Diagne Nafissatou ◽  
Ndao Awa Cheikh ◽  
Thiam Mbaye ◽  
Faye Atoumane ◽  
...  
Keyword(s):  
Adrenal Insufficiency ◽  
Sella Turcica ◽  
Empty Sella

scholarly journals A rare case of hypopituitarism with psychosis

2013 ◽  
Vol 2013 ◽  
Author(s):  
M Nwokolo ◽  
J Fletcher
Keyword(s):  
Adrenal Insufficiency ◽  
Fluid Resuscitation ◽  
Dynamic Testing ◽  
Rare Complication ◽  
False Negative ◽  
Sella Turcica ◽  
Empty Sella ◽  
Electrolyte Imbalance ◽  
List Type ◽  
Presumptive Diagnosis

Summary A 46-year-old woman presented multiple times in a 4-month period with hypotension, sepsis, hypoglycaemia and psychosis. A low random cortisol in combination with her presenting complaint made adrenal insufficiency the likely diagnosis. Fluid resuscitation and i.v. steroid therapy led to clinical improvement; however, a short synacthen test (SST) demonstrated an apparently satisfactory cortisol response. The test was repeated on a later admission and revealed a peak cortisol level of 25 nmol/l (>550 nmol/l). Concurrent treatment with i.v. hydrocortisone had led to a false-negative SST. ACTH was <5 ng/l (>10 ng/l), indicating secondary adrenal failure. We discuss the challenges surrounding the diagnosis of adrenal insufficiency and hypopituitarism, the rare complication of psychosis and a presumptive diagnosis of autoimmune lymphocytic hypophysitis (ALH). Learning points Adrenocortical insufficiency must be considered in the shocked, hypovolaemic and hypoglycaemic patient with electrolyte imbalance. Rapid treatment with fluid resuscitation and i.v. corticosteroids is vital. Polymorphic presentations to multiple specialities are common. Generalised myalgia, abdominal pain and delirium are well recognised, psychosis is rare. A random cortisol can be taken with baseline bloods. Once the patient is stable, meticulous dynamic testing must follow to confirm the clinical diagnosis. The chronic disease progression of ALH is hypothesised to be expansion then atrophy of the pituitary gland resulting in empty sella turcica and hypopituitarism. If hypopituitarism is suspected, an ACTH deficiency should be treated prior to commencing thyroxine (T4) therapy as unopposed T4 may worsen features of cortisol deficiency.

The potentials of magnetic resonance tomography in the diagnosis of the “empty” sella turcica

1994 ◽  
Vol 24 (3) ◽  
pp. 229-233 ◽  
Author(s):  
I. I. Dedov ◽  
T. S. Zenkova ◽  
G. A. Mel'nichenko ◽  
O. I. Belichenko ◽  
I. D. Fedina
Keyword(s):  
Magnetic Resonance ◽  
Sella Turcica ◽  
Magnetic Resonance Tomography ◽  
Empty Sella

THE PRIMARY EMPTY SELLA AN ENDOCRINE STUDY ON 12 CASES

1976 ◽  
Vol 83 (3) ◽  
pp. 483-492 ◽  
Author(s):  
G. Schaison ◽  
J. Metzger
Keyword(s):  
Prolactin Level ◽  
Sella Turcica ◽  
Empty Sella ◽  
Endocrine Function ◽  
Thyrotrophin Releasing Hormone ◽  
Releasing Hormone ◽  
Group A ◽  
Group B ◽  
Lh Releasing Hormone ◽  
Primary Empty Sella

ABSTRACT Twelve patients (10 women and 2 men) with a primary empty sella turcica were studied. Endocrine function tests were performed as follows: growth hormone (GH) was measured after insulin-induced-hypoglycaemia, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) after LH-releasing hormone, thyrotrophin (TSH) and prolactin after thyrotrophin-releasing hormone; pituitary reserve of adrenocorticotrophin (ACTH) was determined by measurement of plasma cortisol after lysinevasopressin and 11 deoxycortisol after metyrapone. Five of the patients (group A) had no endocrine disturbance. Seven patients (group B) had a hypothalamo-pituitary disorder. Two of them had panhypopituitarism which appeared in one case after meningoencephalitis and in the other after a severe cranial trauma. In two cases an amenorrhoea-galactorrhoea syndrome with increased prolactin level (68 and 230 ng/ml) led to a diagnosis of a prolactin producing adenoma, which was confirmed by surgery. Finally three cases of amenorrhoeagalactorrhoea, with normal prolactin level, and/or diabetes insipidus remained unexplained. However, no causal relationship could be demonstrated between the pituitary disturbance and the "empty sella". Primary empty sella turcica is therefore a neuroanatomical and neuroradiological entity with no endocrine implication. A pituitary disorder might suggest a microadenoma or an incidentally associated disease.

scholarly journals Anterior pituitary lobe atrophy as late complication of hemorrhagic fever with renal syndrome

2009 ◽  
Vol 66 (2) ◽  
pp. 166-168
Author(s):  
Dragan Jovanovic ◽  
Zoran Kovacevic ◽  
Tamara Dragovic ◽  
Marijana Petrovic ◽  
Jelena Tadic
Keyword(s):  
Renal Insufficiency ◽  
Anterior Pituitary ◽  
Late Complication ◽  
Sella Turcica ◽  
Hemorrhagic Fever ◽  
Empty Sella ◽  
Acute Stage ◽  
Hantavirus Infection ◽  
Multisystemic Disease ◽  
Acute Renal Insufficiency

Introduction. Hemorrhagic fever with renal syndrome (HFRS) is acute infective multisystemic disease followed by febrility, hemorrhages and acute renal insufficiency. Bleeding in the anterior pituitary lobe leading to tissue necrosis occurs in acute stage of severe clinical forms of HFRS, while atrophy of the anterior pituitary lobe with diminution of the gland function occurs after recovery stage. Case report. We presented a patient with the development of chronic renal insufficiency and hypopituitarism as complication that had been diagnosed six years after Hantavirus infection. Magnetic resonance of the pituitary gland revealed atrophy and empty sella turcica. Conclusion. Regarding frequency of this viral infection and its endemic character in some parts of our country partial and/or complete loss of pituitary function should be considered during the late stage of HFRS.

Misleading normal TSH and persistently elevated creatine kinase: clues to the diagnosis of chronic Sheehan’s syndrome

2021 ◽  
Vol 14 (8) ◽  
pp. e243992
Author(s):  
Ayşe Y Demir ◽  
Christine P Oldenburg-Ligtenberg ◽  
Bianca Loredana Toma-Stan ◽  
Albert van de Wiel
Keyword(s):  
Creatine Kinase ◽  
Postpartum Haemorrhage ◽  
Hormone Replacement ◽  
Sella Turcica ◽  
Reference Interval ◽  
Thyroid Stimulating Hormone ◽  
Empty Sella ◽  
Sheehan’S Syndrome ◽  
Elevated Creatine Kinase ◽  
Sheehan's Syndrome

A 53-year-old woman was referred for medical evaluation of therapy-resistant dyslipidaemia accompanied by elevated creatine kinase levels. Because cessation or alteration of her medication did not improve laboratory abnormalities, hypothyroidism was considered, despite the fact that thyroid stimulating hormone levels were within the reference interval. On further evaluation, she was found to have panhypopituitarism and empty sella turcica as shown by MRI. These findings were unexpected since there was no clinical suspicion during detailed evaluation. When supplementary questions were asked, she brought up a history of severe postpartum haemorrhage 30 years ago, for which she underwent a hysterectomy. Based on these findings, the patient was diagnosed with Sheehan’s syndrome. This syndrome is a rare but potentially life-threatening complication of postpartum haemorrhage, characterised by varying degrees of hypopituitarism that are most commonly presented many years after delivery. The patient recovered after adequate hormone replacement therapy.

Primary hypothyroidism associated with empty sella turcica and hypopituitarism

2021 ◽  
Author(s):  
Chayma Besrour ◽  
Imen Rojbi ◽  
Youssef Lakhoua ◽  
Nadia Mchirgui ◽  
Ibtissem Ben Nacef ◽  
...  
Keyword(s):  
Sella Turcica ◽  
Empty Sella ◽  
Primary Hypothyroidism

The Ubiquitous ‘Empty’ Sella Turcica

1972 ◽  
Vol 13 (P1) ◽  
pp. 413-425 ◽  
Author(s):  
Benjamin Kaufman ◽  
William B. Chamberlin
Keyword(s):  
Sella Turcica ◽  
Empty Sella

scholarly journals Symptomatic hypopituitarism revealing a primary empty sella turcica.

1981 ◽  
Vol 57 (666) ◽  
pp. 235-237
Author(s):  
B. Velkeniers ◽  
D. Desir ◽  
D. Manicourt ◽  
F. Chanoine ◽  
M. Dupont ◽  
...  
Keyword(s):  
Sella Turcica ◽  
Empty Sella ◽  
Primary Empty Sella

The Empty Sella Turcica

1986 ◽  
pp. 167-174 ◽  
Author(s):  
Jean-François Bonneville ◽  
Françoise Cattin ◽  
Jean-Louis Dietemann
Keyword(s):  
Sella Turcica ◽  
Empty Sella

scholarly journals Empty Sella Syndrome in a Postmenopausal Woman

2012 ◽  
Vol 2 (1) ◽  
pp. 52-55
Author(s):  
Sultana Marufa Shefin ◽  
Nazmul Kabir Qureshi
Keyword(s):  
Postmenopausal Woman ◽  
Adrenal Insufficiency ◽  
Postural Hypotension ◽  
Empty Sella ◽  
Electrolyte Imbalance ◽  
Diabetic Woman ◽  
Premature Menopause ◽  
Early Menopause ◽  
Empty Sella Syndrome ◽  
Parasellar Region

A 50-year-old, prematurely postmenopausal diabetic woman was admitted in the Endocrinology department of BIRDEM with the complaints of vomiting, loose motion, lethargy, profound weakness. Previously she suffered from several episodes of electrolyte imbalance and after investigations adrenal insufficiency was diagnosed on 2010. No evaluation was done for her premature menopause. During this episode of illness, she was found with postural hypotension, hyponatremia, dyslipidemia and panhypopituitarism. MRI of sella and parasellar region was done which revealed features suggestive of empty sella. This case gives insight that early menopause warrants proper evaluation and during evaluation, along with other factors hypopituitarism should be considered as an etiology for this condition. DOI: http://dx.doi.org/10.3329/birdem.v2i1.12362 Birdem Med J 2012; 2(1) 52-55

Sign in / Sign up

Export Citation Format

Share Document