title: Where art thou pituitary?
abstract: A middle-aged woman presented with premature menopause and recurrent episodes of vomiting with hyponatraemia. Since primary causes of hormone deficiencies were the only studies initially evaluated, there was a delayed diagnosis. Pituitary tropic hormones (serum thyroid stimulating hormone/follicle stimulating hormone/luteinising hormone), inappropriately low for low-level of target hormones (free thyroxin/oestradiol), led to detailed evaluation of trophic hormone deficiencies by pituitary stimulation. The pituitary stimulation by insulin challenge test confirmed secondary (pituitary) hypofunction. Pituitary imaging revealed an uncommon cause of hypopituitarism, which is discussed in this case report.
authors.affiliation: All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
authors.forename: Vaibhav
authors.initials: V
authors.lastname: Ingle
authors.affiliation: Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
authors.forename: Prafulla Kumar
authors.initials: PK
authors.lastname: Maharana
mesh_terms: D000328:Adult; D002118:Calcium / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D020249:Hormone Replacement Therapy / Q000379:methods*; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage / Q000627:therapeutic use; D007018:Hypopituitarism / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D008594:Menopause, Premature / Q000502:physiology*; D010901:Pituitary Function Tests; D010907:Pituitary Hormones / Q000378:metabolism; D013974:Thyroxine / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome; D014807:Vitamin D / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D010907:Pituitary Hormones; D014807:Vitamin D; D013974:Thyroxine; D002118:Calcium; D006854:Hydrocortisone