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[垂体功能减退所致长QT综合征与多形性室性心动过速。1例报告]

[Long QT syndrome and polymorphic ventricular tachycardia due to hypopituitarism. Report of one case].

作者信息

García-Castro José Miguel, García-Martín Antonia, Guirao-Arrabal Emilio, Carrillo-Alascio Pedro Luis

机构信息

Unidad de Medicina Interna, Hospital La Inmaculada, Almería, España.

Unidad de Endocrinología y Nutrición, Complejo Hospitalario de Granada, Granada, España.

出版信息

Rev Med Chil. 2017 Jul;145(7):941-944. doi: 10.4067/s0034-98872017000700941.

Abstract

Symptoms of hypopituitarism are usually chronic and nonspecific, but rarely the disease can have acute and life threatening manifestations. We report a 53 years old female with a pituitary adenoma that was admitted to our hospital because of syncope. The electrocardiogram showed sinus bradycardia with a prolonged QT interval. Frequent runs of non-sustained polymorphic ventricular tachycardia were noted on telemetry. The patient had a history of severe acute headaches in the previous days and laboratory tests revealed severe secondary hypothyroidism, adrenal insufficiency and a decrease in pituitary hormones. A magnetic resonance imaging of the head showed changes in the size and contrast enhancement of the adenoma. A diagnosis of hypopituitarism secondary to pituitary apoplexy was made and treatment with hydrocortisone and, subsequently, levothyroxine was started. Hormonal disorders such as hypothyroidism, adrenal insufficiency or hypopituitarism should be considered as unusual causes for reversible cardiomyopathy, long QT syndrome and ventricular arrhythmias.

摘要

垂体功能减退的症状通常是慢性且非特异性的,但该病极少会出现急性且危及生命的表现。我们报告一例53岁患有垂体腺瘤的女性患者,因晕厥入院。心电图显示窦性心动过缓伴QT间期延长。遥测发现频发非持续性多形性室性心动过速。该患者在之前几天有严重急性头痛病史,实验室检查显示严重继发性甲状腺功能减退、肾上腺功能不全及垂体激素减少。头部磁共振成像显示腺瘤大小及强化有变化。诊断为垂体卒中继发垂体功能减退,并开始使用氢化可的松治疗,随后使用左甲状腺素。甲状腺功能减退、肾上腺功能不全或垂体功能减退等激素紊乱应被视为可逆性心肌病、长QT综合征和室性心律失常的不常见病因。

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