SEVERE HYPOTENSION AND COMA SECONDARY TO UNRECOGNIZED CHRONIC ANTERIOR HYPOPHYSITIS

被引:6
作者
KAUFMANN, P [1 ]
LAX, SF [1 ]
RADNER, H [1 ]
EBER, B [1 ]
LUEGER, A [1 ]
SMOLLE, KH [1 ]
机构
[1] GRAZ UNIV,DEPT PATHOL,A-8036 GRAZ,AUSTRIA
关键词
ENDOCRINE COMA; HYPOPITUITARY CRISIS; LYMPHOCYTIC HYPOPHYSITIS; HASHIMOTOS DISEASE; REFRACTORY HYPOTENSION;
D O I
10.1007/BF01700970
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
We report an endocrine emergency of a 52-year-old woman with chronic anterior-pituitary failure of autoimmune origin who developed hypopituitary crisis with coma and severe hypotension provoked by an intercurrent bronchopneumonia. At admission to the ICU hypopituitarism had not been diagnosed and only Hashimoto's thyroiditis with thyroid replacement therapy could be obtained from the patient's history. Although the patient presented with somatic signs suggestive of hypopituitarism, other causes of coma and hypotension had first to be excluded. In the absence of specific treatment the patient died 18 h later with refractory cardiac arrest. Diagnosis of acute decompensated chronic hypophyseal failure must be considered if hypothermia, refractory hypotension and signs of infection without fever are associated with a short stature and the loss of axillary and pubic hair. Waiting for laboratory confirmation of the diagnosis must not delay immediate life-saving specific glucocorticoid treatment.
引用
收藏
页码:847 / 849
页数:3
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