Pituitary Apoplexy During Therapy with Cabergoline in an Adolescent Male with Prolactin-Secreting Macroadenoma

Knoepfelmacher, Mirta; Gomes, Miriam C.; Melo, Maria Edna de; Mendonça, Berenice Bilharinho

doi:10.1007/s11102-005-5349-x

Cited by 52 publications

(40 citation statements)

References 33 publications

(53 reference statements)

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“…The main predisposing factors associated to pituitary apoplexy (~25% of cases) are: medication (bromocriptine and cabergoline) [26][27][28] , radiotherapy 29 , pituitary function tests 30,31 , diabetes mellitus, trauma, thrombocytopenia or recent surgery [32][33][34][35][36] . high blood pressure is also considered as a risk factor for pituitary apoplexy although this association is not always seen 1,6 .…”

Section: Predisposing Factorsmentioning

confidence: 99%

Pituitary tumor apoplexy

Chang

Felı́cio

Toscanini

et al. 2009

Arq. Neuro-Psiquiatr.

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-Pituitary tumor apoplexy is a medical emergency due to acute infarction or hemorrhage in the pituitary gland. In this review, the authors discuss the sellar anatomy, the pituitary gland and adenomas' vascularization and the general aspects of the syndrome such as its ethiopatogenesis, predisposing factors, clinical features, treatment and prognosis.Key words: pituitary tumor apoplexy, pituitary, pituitary adenomas. apoplexia em tumor hipofisário resumo -A apoplexia em tumor hipofisário é uma emergência médica decorrente do infarto agudo ou hemorrágico na glândula hipófise. Nesta revisão os autores discutem a anatomia da região selar, a vascularização da hipófise e adenomas hipofisários, e demais aspectos da síndrome como etiopatogenia, fatores predisponentes, quadro clínico, tratamento e prognóstico.PAlAvrAs-chAve: apoplexia hipofisária, hipófise, adenoma hipofisário.

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Section: Predisposing Factorsmentioning

confidence: 99%

Pituitary tumor apoplexy

Chang

Felı́cio

Toscanini

et al. 2009

Arq. Neuro-Psiquiatr.

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“…The patient needed dopamine support to maintain her vital signs during LDLT and re-laparotomy. Knoepfelmacher et al reported that a causal relationship between dopamine agonist (bromocriptine) and apoplexy has been suggested because adenomas have sometimes shown necrosis at surgery after bromocriptine treatment [11,12]. This patient received the dopamine agonist only because of the surgery, so this factor might be associated with this complication.…”

Section: Discussionmentioning

confidence: 97%

Pituitary apoplexy precipitating diabetes insipidus after living donor liver transplantation

et al. 2011

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Pituitary apoplexy occurring after surgery is a rare but life-threatening acute clinical condition that follows extensive hemorrhagenous necrosis within a pituitary adenoma. Pituitary apoplexy has been reported to occur spontaneously in the majority of cases or in association with various inducing factors. Reported is a case of pituitary apoplexy complicated by diabetes insipidus following living donor liver transplantation (LDLT). To the best of our knowledge, this has not been previously reported. A 56-year-old woman with nonalcoholic steatohepatitis underwent LDLT from her daughter. The patient also required dopamine support and transfusions because of massive intraoperative bleeding. Postoperatively, her coagulopathy continued, and she underwent a second laparotomy because of unknown bleeding on postoperative day 7, when she needed transfusions and dopamine support to maintain her vital signs. She complained of severe headache, excessive thirst, frequent urination, and diplopia from postoperative day 10. She also had polyuria greater than 300 ml/h and was diagnosed with pituitary apoplexy precipitating diabetes insipidus on postoperative day 13. She was treated conservatively without surgery because of the hormonally inactive status and slight mass effect of her tumor. It is important for anesthesiologists and critical care personnel in LDLT settings to take into consideration this complication as a differential diagnosis.

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“…Several suggested risk factors that predispose a tumor to apoplexy include tumor size, nonfunctioning or prolactin-producing subtypes, invasion of the The level of compression was above the left posterior communicating artery, as seen on lateral left common angiography (c, black arrow). Postoperative MRI shows extensive resection of the prolactinoma with some residual tumor along the left cavernous sinus (d) cavernous sinus, and coagulopathy [5][6][7][8][9][10][11]. Though no rate is reported, pituitary apoplexy is rare in the pediatric population.…”

Section: Discussionmentioning

confidence: 99%