title: [Clinical thinking and decision making in practice. A patient with postpartum malaise, anorexia, and ventricular tachycardia].
abstract: A 34-year-old woman was hospitalised with hypotension, lethargy and ventricular tachycardia, five months after an uneventful pregnancy and delivery. Laboratory values were compatible with anterior (abnormal concentrations of adrenocorticotropin hormone, thyroid stimulating hormone, prolactin) and posterior (diabetes insipidus) pituitary gland insufficiency. An MRI scan revealed that there was no pituitary enlargement and that the pituitary stalk was normal. The prompt recognition of hypophysitis as a potentially fatal condition is important, as a life-saving treatment is available.
authors.affiliation: Ziekenhuis Rijnstate, afd. Inwendige Geneeskunde, Postbus 9555, 6800 TA Arnhem. pkamphuisen@rijnstate.nl
authors.forename: P W
authors.initials: PW
authors.lastname: Kamphuisen
authors.forename: M
authors.initials: M
authors.lastname: Levi
authors.forename: H A
authors.initials: HA
authors.lastname: Kaasjager
mesh_terms: D000208:Acute Disease; D000328:Adult; D000855:Anorexia / Q000209:etiology*; D001327:Autoimmune Diseases / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D020249:Hormone Replacement Therapy / Q000379:methods; D006801:Humans; D007018:Hypopituitarism / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D007022:Hypotension / Q000209:etiology; D008279:Magnetic Resonance Imaging; D010901:Pituitary Function Tests; D010902:Pituitary Gland / Q000473:pathology*; D010911:Pituitary Neoplasms / Q000175:diagnosis; D049590:Postpartum Period; D011247:Pregnancy; D012894:Sleep Stages; D017180:Tachycardia, Ventricular / Q000209:etiology*; D013967:Thyroiditis, Autoimmune / Q000175:diagnosis
vernacular_title: Klinisch denken en beslissen in de praktijk. Een patiënte met post partum ontstane algehele malaise, anorexie en ventriculaire tachycardieën.