Department of Endocrinology and Metabolism Disease, Ege University Medical School, 35100, Izmir, Turkey.
Endocrine. 2010 Oct;38(2):143-6. doi: 10.1007/s12020-010-9367-8. Epub 2010 Jul 14.
Adrenocorticotropin (ACTH) producing macroadenomas and pituitary apoplexy are unusual in Cushing' s disease. A 20-year-old man who had been diagnosed Cushing' s disease 2 months ago, presented with sudden headache, nausea, and vomiting. His serum cortisol level was 0.4 μg/dl and ACTH level was 23.9 pg/ml. Magnetic resonance imaging of the pituitary gland disclosed a hemorrhage in the pituitary macroadenoma (22×19 mm). He was treated with IV methylprednisolone immediately and then the symptoms were relieved within the first day of the treatment. The hemorrhagic lesion was resected by transsphenoidal surgery successfully. Impaired secretion of pituitary hormones may be seen after the pituitary apoplexy. We communicate a case with pituitary apoplexy of an ACTH secreting pituitary macroadenoma, causing acute glucocorticoid insufficiency.
促肾上腺皮质激素（ACTH）产生的大腺瘤和垂体卒中在库欣病中并不常见。一位 20 岁的男性，2 个月前被诊断为库欣病，突然出现头痛、恶心和呕吐。他的血清皮质醇水平为 0.4μg/dl，ACTH 水平为 23.9pg/ml。垂体磁共振成像显示垂体大腺瘤（22×19mm）出血。他立即接受了 IV 甲基强的松龙治疗，治疗的第一天症状就得到了缓解。通过经蝶窦手术成功切除了出血病变。垂体卒中后可能会出现垂体激素分泌不足。我们报告了一例 ACTH 分泌性垂体大腺瘤引起的垂体卒中，导致急性糖皮质激素不足的病例。
