Zayour Dany H, Azar Sami T
Division of Endocrinology, Beirut Governmental University Hospital, Beirut, Lebanon.
Endocr Pract. 2006 Jan-Feb;12(1):59-62. doi: 10.4158/EP.12.1.59.
To report a case of silent pituitary infarction that occurred after a coronary artery bypass grafting procedure and review the relevant literature.
We describe a female patient with silent pituitary infarction several months after a coronary artery bypass operation and discuss her presentation, clinical findings, and laboratory evaluation. We also review similar cases in the literature.
A 73-year-old woman presented with generalized fatigue, weakness, and an elevated creatine kinase level several months after she had undergone a coronary artery bypass procedure. The findings on laboratory evaluation were consistent with hypogonadism, growth hormone deficiency, central hypothyroidism, and adrenal insufficiency. Magnetic resonance imaging of the pituitary fossa showed an empty sella turcica and no sellar enlargement. The patient had no headaches, no neuro-ophthalmologic symptoms, and no focal neurologic deficits. The presentation was slow and insidious. The patient received glucocorticoid and thyroid hormone replacement therapy, after which her clinical status improved substantially. Silent pituitary infarction after coronary artery bypass grafting has been reported previously in 3 male patients, but our current case is the first such report in a female patient.
Silent pituitary infarction can be a complication of a coronary artery bypass grafting procedure, with a delayed and insidious presentation.
报告一例冠状动脉搭桥手术后发生的无症状垂体梗死病例，并复习相关文献。
我们描述了一名女性患者，在冠状动脉搭桥手术后数月出现无症状垂体梗死，并讨论了她的临床表现、临床检查结果及实验室评估情况。我们还复习了文献中的类似病例。
一名73岁女性在接受冠状动脉搭桥手术后数月出现全身乏力、虚弱及肌酸激酶水平升高。实验室评估结果符合性腺功能减退、生长激素缺乏、中枢性甲状腺功能减退及肾上腺皮质功能不全。垂体窝磁共振成像显示蝶鞍空虚，无蝶鞍增大。患者无头痛、无神经眼科症状及局灶性神经功能缺损。病情呈缓慢隐匿性发展。患者接受了糖皮质激素及甲状腺激素替代治疗，此后临床状况显著改善。此前曾有3例男性患者报道过冠状动脉搭桥术后无症状垂体梗死，但我们目前的病例是首例女性患者。
无症状垂体梗死可能是冠状动脉搭桥手术的一种并发症，表现为延迟且隐匿。
