Hypopituitarism Crisis:a Case Report And Literature Review

Objective: To investigate the clinical characteristics,diagnosis and treatment of hypopituitarism crisis.Methods: A case report about a patient who suffered from hypopituitarism crisis is presented,and related literatures are reviewed.History: The patient has a history of pituitary adenoma surgery and then she was diagnosed with hypopituitarism in our department in 2013.Several days before this hospital admission,the patient suffered a cold in the travel and reduced the drug dosage.After admission,the patient presented with high fever,lethargy,coma,decreased blood pressure,electrolyte disturbance,low oxygen saturation,which were eligible for the diagnosis of hypopituitarism crisis.Treatment: High dose hydrocortisone and thyroid hormone was given to treat pituitary crisis,and antibiotics was prescribed for pulmonary infection,mechanical ventilation was employed as well.Results: The patient was turned conscious,and blood pressure,heart rate,oxygen saturation become steady,pituitary crisis was corrected,pulmonary infection was controlled.Hormone replacement therapy sustained after discharge.Conclusion: Patients with hypopituitarism can cause pituitary crisis under many circumstances,such as various stress or sudden withdrawal of drugs and so on,which will be life-threatening and belongs to the clinical critical disease,diagnosis and treatment should be timely and effective.The early symptoms of hypopituitarism are often not obvious,especially in the elderly patients,it is easy to misdiagnose,so clinicians should strengthen the understanding of the disease,and emphasize the importance of hormone replacement therapy after diagnosis.