[Pituitary coma].
Severe or inadequately substituted insufficiency of corticotropic and/or thyrotropic pituitary axes may induce a life-threatening coma. Without any information on patient history the primary diagnosis is difficult but clinical signs of hypogonadism may be helpful. Laboratory diagnostics reveal low serum concentrations of the hormones of the pituitary and the target organs. Low sodium concentrations are induced by stimulated ADH secretion and coincidental hypoglycemia may aggravate the situation. Initial treatment is based on the early substitution of hydrocortisone and is followed by thyroxine substitution according to the laboratory results at an intensive care unit where other coincidental problems also need to be monitored and treated. Differential diagnosis of pituitary pathology and definition of long-term treatment follow after stabilization of the patient's condition.
Bereich Endokrinologie & Diabetologie und Zentrum für In-Vitro-Diagnostik - Endokrinologie, Philipps-Universität Marburg und UKGM Universitätsklinikum Marburg, 35033, Marburg, Deutschland. kannp@med.uni-marburg.de
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Kann
D000324:Adrenocorticotropic Hormone / Q000097:blood / Q000172:deficiency*; D003128:Coma / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D003422:Critical Care; D003937:Diagnosis, Differential; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage; D007003:Hypoglycemia / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D007018:Hypopituitarism / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy*; D007177:Inappropriate ADH Syndrome / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D012964:Sodium / Q000097:blood; D013972:Thyrotropin / Q000097:blood / Q000172:deficiency*; D013974:Thyroxine / Q000008:administration & dosage
D000324:Adrenocorticotropic Hormone; D013972:Thyrotropin; D012964:Sodium; D013974:Thyroxine; D006854:Hydrocortisone