Open AccessA Case with Empty Sella Syndrome Combined with Multiple Anterior Pituitary Hormone Deficiencies Presenting as Hypoglycemic Coma
Author(s) -
Sang-Yong Kim,
Sung Su Kim,
Bo Ra Kim,
Jung Hwa Jung,
Jae Hoon Jung,
Jong Ryeal Hahm
Publication year - 2014
Publication title -
gosin daehakgyo uigwa daehak haksulji/kosin medical journal
Language(s) - English
Resource type - Journals
eISSN - 2586-7024
pISSN - 2005-9531
DOI - 10.7180/kmj.2014.29.2.151
Subject(s) - medicine , hypoglycemia , anterior pituitary , prolactin , endocrinology , luteinizing hormone , hormone , hypopituitarism , hydrocortisone , empty sella syndrome , insulin , diabetes mellitus
A 55-year-old male was admitted to emergency department with a hypoglycemic shock of unknown origin. He was presented with tonic seizure activity after admission. Initial diagnostic procedure could exclude diabetes mellitus, drug side effects, and exogenous insulin application. Detailed evaluation of the patient's history revealed that the patient had experienced repeated hypoglycemic episodes for 2 years. He was diagnosed with hypothyroidism six years ago. Initial laboratory investigations revealed hypoglycemia, hyponatremia, and low plasma cortisol level (0.18 pg/dᄂ)· Sellar magnetic resonance imaging showed empty sella. Replacement therapy with hydrocortisone resulted in the improvement of clinical symptoms. Combined pituitary stimulation test with exception of hypoglycemia induced growth hormone and cortisol stimulation test was performed. The response of thyroid stimulating hormone, prolactin, follicle-stimulating hormone, and luteinizing hormone was normal. We report the case of empty sella syndrome associated with hypoglycemic shock due to with multiple anterior pituitary hormone deficiencies.