title: Recurrent dizzy spells: all in the head!
abstract: Hypoglycaemia is an uncommon manifestation of hypopituitarism in non-diabetic adults. A 47-year-old woman with Cushing's disease was treated with bilateral adrenalectomy and pituitary radiotherapy following unsuccessful trans-sphenoidal surgery. Twenty years later, she presented with a tonic-clonic seizure and recurrent symptoms suggestive of spontaneous hypoglycaemia. Her symptoms continued despite manipulation of her glucocorticoid replacement therapy. Recurrent severe hypoglycaemia resolved after identification and treatment of her concomitant growth hormone deficiency. In patients with hypopituitarism, undiagnosed growth hormone deficiency can influence glucose metabolism and predispose to severe hypoglycaemia.
authors.affiliation: Metabolic Unit, Western General Hospital, Crewe Road, Edinburgh EH4 2XU, UK.
authors.forename: Vincent
authors.initials: V
authors.lastname: McAulay
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Seckl
authors.forename: Mark W J
authors.initials: MW
authors.lastname: Strachan
mesh_terms: D004198:Disease Susceptibility; D004244:Dizziness / Q000188:drug therapy / Q000378:metabolism*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D005947:Glucose / Q000378:metabolism*; D013006:Growth Hormone / Q000097:blood / Q000172:deficiency*; D006801:Humans; D007003:Hypoglycemia / Q000188:drug therapy / Q000209:etiology*; D007018:Hypopituitarism / Q000188:drug therapy / Q000209:etiology*; D008875:Middle Aged
chemical_list: D005938:Glucocorticoids; D013006:Growth Hormone; D005947:Glucose