Acute Sterile Meningitis as a Primary Manifestation of Pituitary Apoplexy.

AACE Clinical Case Reports
Gayane TumyanMark Feldman

Abstract

We report a case of pituitary apoplexy (PA) with negative radiographic findings for PA and cerebrospinal fluid (CSF) analysis consistent with neutrophilic meningitis. PA is a rare endocrinopathy requiring prompt diagnosis and treatment. Presentation with acute neutrophilic meningitis is uncommon. The diagnostic modalities included pituitary function tests (adrenocorticotropic hormone, thyroid-stimulating hormone, luteinizing hormone, prolactin), brain computed tomography and magnetic resonance imaging (MRI), and CSF analysis. A 67-year-old man presented with worsening headache, nausea, and retching. He was somnolent with an overall normal neurologic examination other than a peripheral vision defect in the left eye. MRI showed a pituitary mass bulging into the suprasellar cistern with optic chiasm elevation, consistent with pituitary macroadenoma. Laboratory evaluation revealed decreased levels of adrenocorticotropic hormone, random cortisol, thyroid-stimulating hormone, thyroxine, luteinizing hormone, and testosterone. He had worsening encephalopathy with left eye ptosis and decreased vision, prompting a repeat computed tomography and MRI, showing no interval change in the pituitary adenoma or evidence of bleeding. CSF analysis...Continue Reading

References

May 1, 1990·Journal of Neurology, Neurosurgery, and Psychiatry·J B Winer, G Plant
Sep 1, 1999·Clinical Endocrinology·H S RandevaJ A Wass
Sep 19, 2001·Journal of Neurology, Neurosurgery, and Psychiatry·V BiousseN M Oyesiku
Dec 13, 2003·Journal of Endocrinological Investigation·M ValenteF Santeusanio
Feb 26, 2004·Headache·Davinder S JassalJohn M Embil
Jun 9, 2004·Lancet·R C W MaC S Cockram
Dec 20, 2007·Neurosurgery·Patrick L SempleEdward R Laws
Mar 29, 2008·Journal of Intensive Care Medicine·Rita N NawarBaha M Arafah
Jun 27, 2009·The American Journal of Emergency Medicine·Wen-Yi HuangHsien-Chih Chen
Oct 7, 2011·International Journal of Emergency Medicine·Ahmed-Ramadan SadekThiagarajan Jaiganesh
Jun 7, 2014·Brain Tumor Research and Treatment·Keun OhSe-Hyuk Kim
Oct 16, 2014·Insights Into Imaging·Alessandro BoellisAlessandro Bozzao
Apr 11, 2015·Journal of Neurosurgery·Tarun D SinghAlejandro A Rabinstein
Sep 29, 2015·Endocrine Reviews·Claire BrietPhilippe Chanson
Jan 12, 2017·International Journal of Endocrinology·Adriana AlbaniSalvatore Cannavò
Aug 25, 2018·Endocrine Connections·Ali AbbaraNiamh M Martin

❮ Previous
Next ❯

Related Concepts

Related Feeds

Bacterial Meningitis (ASM)

Bacterial meningitis continues to be an important cause of mortality and morbidity throughout the world. Here is the latest research.

CSF & Lymphatic System

This feed focuses on Cerebral Spinal Fluid (CSF) and the lymphatic system. Discover the latest papers using imaging techniques to track CSF outflow into the lymphatic system in animal models.

Bacterial Meningitis

Bacterial meningitis continues to be an important cause of mortality and morbidity throughout the world. Here is the latest research.