Davis Anu, Goel Shefali, Picolos Michalis, Wang Min, Lavis Victor
University of Texas Health Science Center - Houston, 6431 Fannin, MSB 4.202, Houston, TX 77030, USA.
Pituitary. 2006;9(3):263-5. doi: 10.1007/s11102-006-8616-6.
Clinically unsuspected pituitary adenomas are common among adults on autopsy and MRI survey. Acute pituitary hemorrhage is far more rare. We report a case of a 61-year-old male patient with locally advanced prostate cancer who presented with an acute picture of pituitary apoplexy after his first dose of leuprolide. He developed headache and neck pain within a few hours of treatment followed by nausea, vomiting, ptosis and diplopia. Pituitary apoplexy is a potentially life threatening medical emergency. Although the pathophysiology is poorly defined, various conditions and treatments have been reported to trigger apoplexy. Apoplexy has been reported in response to pituitary stimulation by GnRH or GnRH-agonists. Initial stimulatory effects of gonadotropin releasing hormone (GnRH) analogue may induce apoplexy in patients with asymptomatic gonadotroph adenomas.
临床上未被怀疑的垂体腺瘤在成人尸检和MRI检查中很常见。急性垂体出血则更为罕见。我们报告一例61岁男性患者，患有局部晚期前列腺癌，在首次注射亮丙瑞林后出现垂体卒中的急性症状。他在治疗后数小时内出现头痛和颈部疼痛，随后出现恶心、呕吐、上睑下垂和复视。垂体卒中是一种潜在的危及生命的医疗急症。尽管其病理生理学尚未明确，但据报道，多种情况和治疗方法可引发卒中。已有报告称，促性腺激素释放激素（GnRH）或GnRH激动剂刺激垂体可导致卒中。促性腺激素释放激素（GnRH）类似物的初始刺激作用可能会在无症状促性腺激素腺瘤患者中诱发卒中。
