Pituitary Apoplexy causing Reversible Visual Field Defect in a 45-year old Female with Dengue Hemorrhagic Fever

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 163-194-Pituitary Disorders & Case Reports
Basic/Clinical
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-190
Katherine Avellaneda Valeros*1 and Kok-Onn Lee2
1National University Hospital, Singapore, Singapore, 2Natl Univ of Singapore, Singapore, Singapore
Pituitary apoplexy is a rare, sometimes fatal event, presenting with headache, nausea, vomiting, visual loss, ophthalmoplegia, hypopituitarism, hemodynamic instability.  It usually happens in individuals with pituitary tumor.  It has no known direct cause, but many conditions are associated with it.  Precipitating factors include reduced or acute increase in blood flow, stimulation of the pituitary gland and an anti-coagulated state.  Other associated factors are male gender, tumor size and tumor type.  Dengue hemorrhagic fever (DHF) is characterized by an anti-coagulated state.  Hypovolemia and, occasionally, hypotension may also be present.  These features can precipitate bleeding, infarction or both.  This is a case report of a 45-year old Chinese female diagnosed with Acromegaly and underwent pituitary surgery and radiotherapy 20 years ago.  She experienced headache and bitemporal hemianopia with concurrent DHF.  Clinical manifestations and imaging of the brain confirmed the diagnosis of pituitary apoplexy.  After several weeks of expectant management and withholding surgery, reversal of visual defect was noted with minimal reduction in size of the mass

Nothing to Disclose: KAV, KOL

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