Pituitary apoplexy in a patient with acute myeloid leukemia and thrombocytopenia.
We describe a 72-year-old woman with a history of acute myeloid leukemia who developed pituitary apoplexy associated with thrombocytopenia secondary to chemotherapy. She presented with new onset severe headache, nausea, vomiting and blurred vision. Initial physical examination was unremarkable. CT scan of the head was initially negative. Upon admission for further work up, She developed a high-grade fever, hypotension and obtundation. Subsequent physical examination revealed bitemporal visual fields defects and decreased visual acuity. Repeat imaging of head revealed a hemorrhagic pituitary mass compressing the optic chiasm. Laboratory results were compatible with the diagnosis of pan-hypopituitary syndrome. She received high dose steroids and was transferred for transnasal sphenoidotomy decompression surgery. The visual defects improved postoperatively. A literature review of Pituitary apoplexy is presented. Pituitary apoplexy secondary to thrombocytopenia has never been reported.
Wongpraparut
N
N
Department of Medicine, Albert Einstein Medical Center, 5401 Old York Road, Philadelphia, PA 19141, USA. Nattawut@AOL.COM
Pleanboonlers
N
N
Suwattee
P
P
Rerkpattanapipat
P
P
Turtz
A
A
Moster
M
M
Gala
I
I
Kim
Y N
YN
D000236:Adenoma / Q000473:pathology; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D003561:Cytarabine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007948:Leukemia, Monocytic, Acute / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D008279:Magnetic Resonance Imaging; D010899:Pituitary Apoplexy / Q000209:etiology* / Q000473:pathology; D010902:Pituitary Gland / Q000000981:diagnostic imaging / Q000473:pathology; D010911:Pituitary Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D011859:Radiography; D013921:Thrombocytopenia / Q000150:complications* / Q000188:drug therapy
D000964:Antimetabolites, Antineoplastic; D003561:Cytarabine