Huang Denis, Kreitler Kristin, Tilton Scott, Cavarocchi Nicholas C, Hirose Hitoshi
Surgery, Thomas Jefferson University, Philadelphia, USA.
Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, USA.
Cureus. 2019 Jun 25;11(6):e4995. doi: 10.7759/cureus.4995.
We present a 58-year-old female with a past history of a pituitary adenoma resected two years prior to admission who developed polymorphic ventricular tachycardia and cardiogenic shock requiring veno-arterial extracorporeal membrane oxygenation (VA-ECMO). We noted that the patient had stopped taking all of her medications six months prior to presentation. An extensive workup revealed acute panhypopituitarism with secondary hypothyroidism, secondary adrenal insufficiency, and central diabetes insipidus. She was immediately initiated on thyroid and adrenal hormone replacement therapy as well as fluid replacement. Within five days of her medical treatment, the patient's cardiac function improved and she was successfully weaned from VA-ECMO and subsequently discharged home with appropriate hormone replacement therapy.
我们报告一名58岁女性,入院前两年有垂体腺瘤切除病史,此次发生多形性室性心动过速和心源性休克,需要静脉-动脉体外膜肺氧合(VA-ECMO)治疗。我们注意到患者在就诊前六个月已停用所有药物。全面检查发现急性全垂体功能减退,继发甲状腺功能减退、继发性肾上腺皮质功能不全和中枢性尿崩症。她立即开始接受甲状腺和肾上腺激素替代治疗以及补液治疗。在接受药物治疗的五天内,患者的心功能得到改善,成功脱离VA-ECMO,随后接受适当的激素替代治疗后出院回家。