垂体卒中可能是由促甲状腺激素释放激素（TRH）和促性腺激素释放激素（GnRH）刺激试验导致，该患者患有肢端肥大症。

Pituitary apoplexy probably due to TRH and GnRH stimulation tests in a patient with acromegaly.

作者信息

Dökmetaş H S, Selçuklu A, Colak R, Unlühizarci K, Bayram F, Keleştimur F

机构信息

Department of Endocrinology, Erciyes University, Medical School, Kayseri, Turkey.

出版信息

J Endocrinol Invest. 1999 Oct;22(9):698-700. doi: 10.1007/BF03343632.

DOI:10.1007/BF03343632

PMID:10595834

Abstract

Pituitary apoplexy is the most serious and life-threatening complication of pituitary adenomas. Most of the cases occur spontaneously but it may occur also after a number of events such as the pituitary stimulation tests. We report a case of acromegaly due to a giant pituitary adenoma in which pituitary apoplexy developed 88 hours after TRH/GnRH stimulation test. The patient had severe headaches, nausea, vomiting, visual disturbance and mental alteration and the computed tomography (CT) scans revealed intratumoral and intraventricular bleeding. The pituitary mass was removed by transsphenoidal approach. The patient developed pneumonia and died on the 9th postoperative day. Pituitary apoplexy was confirmed at surgery and on histological examination. Immunohistochemical staining was positive for GH and PRL. This case indicates that pituitary apoplexy may develop several days after TRH/GnRH stimulation test.

摘要

垂体卒中是垂体腺瘤最严重且危及生命的并发症。大多数病例为自发性发生，但也可能在垂体刺激试验等一系列事件后出现。我们报告一例因巨大垂体腺瘤导致的肢端肥大症患者，该患者在促甲状腺激素释放激素/促性腺激素释放激素刺激试验88小时后发生垂体卒中。患者出现严重头痛、恶心、呕吐、视力障碍和精神改变，计算机断层扫描（CT）显示肿瘤内及脑室内出血。经蝶窦入路切除垂体肿块。患者术后发生肺炎，于术后第9天死亡。手术及组织学检查确诊为垂体卒中。免疫组化染色显示生长激素（GH）和催乳素（PRL）呈阳性。该病例表明垂体卒中可能在促甲状腺激素释放激素/促性腺激素释放激素刺激试验数天后发生。