[A case of sudden death of a patient with hypopituitarism].
We report a 29-year-old woman who died due to pituitary insufficiency. After a normal delivery 2 years previously, she had suffered from amenorrhea and displayed decreased libido. She was discovered in convulsions by her husband when he returned home, and was admitted to an emergency hospital. Despite various treatments, she died. Her blood glucose level on admission was low, 32 mg/dl. Autopsy findings showed thin public hair and almost no axillary hair. The right and left adrenal glands weighed 1.7 g and 1.2 g, respectively. Histologically, the anterior pituitary gland showed severe bleeding and necrosis, and the middle lobe showed lymphocytic infiltration; the posterior lobe was almost normal. The adrenal glands showed marked atrophy of the cortex and deposition of calcium in the medulla. The thyroid gland, which weighted 15 g, showed diffuse interstitial lymphocytic infiltration, indicative of chronic lymphocytic thyroiditis. Atrophy of the ovaries and uterine endometrium was also observed. These findings indicated that death had been due to pituitary insufficiency. The histopathology of the pituitary, which showed lymphoid hypophysitis, and its association with lymphoid thyroiditis suggested that the pituitary insufficiency was not due to ischemic injury after delivery, a condition which can result from massive hemorrhage, but rather had arisen as a result of an autoimmune process.
Department of Legal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
K
K
Hatake
A
A
Kubota
T
T
Taniguchi
M
M
Negoro
H
H
Ouchi
T
T
Minami
S
S
Hishida
D003645:Death, Sudden / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D007018:Hypopituitarism / Q000150:complications* / Q000473:pathology; D010903:Pituitary Gland, Anterior / Q000473:pathology