Endocrinology Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal.
Paediatric Endocrinology Unit, Centro Hospitalar e Universitário do Porto, Porto, Portugal.
J Pediatr Endocrinol Metab. 2021 Apr 5;34(6):799-803. doi: 10.1515/jpem-2020-0499. Print 2021 Jun 25.
Pituitary apoplexy is a rare complication of Cushing's disease (CD), especially in the paediatric age and even more rarely it can occur following anterior pituitary stimulation tests.
We report a case of a 14-year-old girl who was admitted to our Hospital for evaluation of a possible Cushing's syndrome (CS). Her symptoms and initial laboratory tests were suggestive of CD. Magnetic resonance imaging (MRI) revealed a microadenoma of the pituitary gland. As part of her evaluation she was submitted to a corticotropin-releasing hormone (CRH) stimulation test. Two and a half months later the patient was re-evaluated and presented with both clinical improvement of CS, biochemical resolution of hypercortisolism and tumour size reduction in the MRI, also evidencing a haemorrhagic component favouring the diagnosis of pituitary apoplexy after CRH stimulation test. The patient denied any episodes of severe headache, nausea, vomiting or visual changes.
To our knowledge, the authors report the first case of a pituitary apoplexy after a CRH stimulation test in the paediatric age.
垂体卒中是库欣病（CD）的一种罕见并发症，特别是在儿童期，甚至在接受垂体前叶刺激试验后更为罕见。
我们报告了一例 14 岁女孩的病例，她因疑似库欣综合征（CS）而被收入我院。她的症状和初步实验室检查提示为 CD。磁共振成像（MRI）显示垂体微腺瘤。作为评估的一部分，她接受了促皮质素释放激素（CRH）刺激试验。两个半月后，患者再次接受评估，CS 的临床症状改善，皮质醇增多症的生化指标恢复正常，MRI 显示肿瘤缩小，且有出血成分，支持 CRH 刺激试验后垂体卒中的诊断。患者否认有严重头痛、恶心、呕吐或视力改变的症状。
据我们所知，作者报告了首例儿童期 CRH 刺激试验后发生的垂体卒中病例。
