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Pituitary apoplexy and sudden blindness following the administration of gonadotrophin releasing hormone
Author(s) -
Masson Ewan A.,
Atkin Stephen L.,
Diver Michael,
White Michael C.
Publication year - 1993
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.1993.tb00980.x
Subject(s) - pituitary apoplexy , medicine , pituitary adenoma , endocrinology , pituitary gland , hormone , complication , adenoma , surgery
Summary Pituitary apoplexy has been reported as a rare complication of combined tests and of TRH administration in prolactinomas. A 54‐year‐old man with a pituitary macro‐adenoma had a single injection of 100 μg GnRH. Twenty minutes later he complained of increasing headache and vomited. These symptoms settled spontaneously and were attributed to the pharmacological effects of GnRH. Five hours later he was found to be blind and disorientated without spontaneous complaint. Emergency CT showed a large adenoma with central necrosis, consistent with pituitary apoplexy. An urgent surgical decompression was carried out and necrotic haemorrhagic debris removed. Baseline bloods revealed non‐pulsatile FSH of 40 U/I with LH 0.3 U/I with no hormonal response to GnRH administration, but the sequence of events strongly suggests a causal relationship between this and pituitary apoplexy. To our knowledge this is the first time that GnRH administration has been associated with pituitary apoplexy of a glycoprotein secreting pituitary adenoma.