Pituitary apoplexy with spontaneous cure of acromegaly and its possible relation to Gd-DTPA-administration.
A case of pituitary apoplexy occurring after Gd-DTPA-administration for contrast enhanced MRI in a patient with an hGH-producing macro-adenoma is presented. Within days the initially increased hGH level fell to the normal range, the oral glucose tolerance test (OGTT) showed a normal suppression of hGH and complete anterior pituitary insufficiency developed. At this time repeated MRI suggested a haemorrhagic infarction of the macro-adenoma. Fourteen months later re-examination confirmed spontaneous cure of the acromegaly, improvement of adenopituitary function and shrinkage of the sellar content. The causal linkage between the pituitary adenoma apoplexy and Gd-DTPA-administration is unclear. It might be due to contrast induced blood pressure and endothelial permeability changes, possibly promoted by pre-existing diabetes mellitus associated vasculopathy.
Wichers
M
M
Department of Clinical Biochemistry, University of Bonn, Federal Republic of Germany.
Kristof
R A
RA
Springer
W
W
Schramm
J
J
Klingmüller
D
D
D000172:Acromegaly / Q000175:diagnosis*; D000236:Adenoma / Q000097:blood / Q000175:diagnosis; D000328:Adult; D003287:Contrast Media / Q000008:administration & dosage*; D005500:Follow-Up Studies; D019786:Gadolinium DTPA / Q000008:administration & dosage*; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010899:Pituitary Apoplexy / Q000097:blood / Q000175:diagnosis*; D010902:Pituitary Gland / Q000473:pathology; D010911:Pituitary Neoplasms / Q000097:blood / Q000175:diagnosis; D012075:Remission, Spontaneous
D003287:Contrast Media; D019382:Human Growth Hormone; D019786:Gadolinium DTPA