Hemorrhagic pituitary apoplexy in an 18 year-old male presenting as non-Ketotic hyperglycemic coma (NKHC)

Manmohan K. Kamboj, Ping Zhou, Walter J. Malofsky, Bonita Franklin, Bina Shah, Raphael David, Brenda Kohn

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Pituitary apoplexy is an acute clinical event usually caused by hemorrhage or infarction in a pituitary adenoma. We report the unusual case of hemorrhagic pituitary apoplexy in an 18 year-old male with previously undiagnosed type 2 diabetes mellitus who presented with unexplained hyperglycemia (glucose 49.2 mmol/l [887 mg/dl]) and obtundation and in whom an initial diagnosis of non-ketotic hyperglycemic coma (NKHC) was made. MRI revealed a heterogeneous mass arising from an expanded sella turcica into the suprasellar cistern. Despite well-controlled glucose levels on continuous insulin infusion, dexamethasone, and initiation of bromoergocriptine (parlodel) therapy, the patient's vision and pupillary responses deteriorated acutely. Following emergency transphenoidal surgery, the patient's vision and mental status improved. Data confirmed preoperative panhypopituitarism; serum prolactin was 396 ng/ml (μg/l). Immunostudies demonstrated tumoral labeling for prolactin, but not for ACTH, GH, TSH, LH, FSH, or P53.

Original languageEnglish (US)
Pages (from-to)611-615
Number of pages5
JournalJournal of Pediatric Endocrinology and Metabolism
Volume18
Issue number6
DOIs
Publication statusPublished - Jun 2005
Externally publishedYes

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Keywords

  • Non-ketotic hyperglycemic come (NKHC)
  • Pituitary apoplexy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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