title: Acute psychosis as a presentation of hypopituitarism.
abstract: Acute onset neuropsychiatric manifestations in hypopituitarism are uncommon. We report a case of a 60-year-old man who was a follow-up case of macroprolactinoma with hypopituitarism for the last 9 years. He was on medical treatment with cabergoline, thyroxine and depot testosterone. During the last 2 years he was non-adherent to medications especially cabergoline. He was hospitalised for 2 days through emergency services following acute onset psychosis. His pituitary hormone profile was suggestive of adrenal insufficiency, secondary hypothyroidism and hypogonadism. MRI of the hypothalamic pituitary region revealed a pituitary macroadenoma which was larger in size compared to the previous scan. Further, this lesion was compressing on the adjoining structures including optic chiasma. The patient was treated with intravenous fluids, hydrocortisone and thyroxine replacement therapy. With this treatment he completely recovered from psychosis within 48 h.
authors.affiliation: Department of Medicine, Maulana Azad Medical College, New Delhi, India.
authors.forename: Shruti
authors.initials: S
authors.lastname: Kate
authors.forename: Dinesh Kumar
authors.initials: DK
authors.lastname: Dhanwal
authors.forename: Shishir
authors.initials: S
authors.lastname: Kumar
authors.forename: Praveen
authors.initials: P
authors.lastname: Bharti
mesh_terms: D000208:Acute Disease; D006801:Humans; D007018:Hypopituitarism / Q000150:complications* / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000209:etiology*