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Anterior hypopituitarism due to primary empty sella syndrome in a critically unwell patient
  1. Mariya Rajesh1,
  2. Tahir Omer2 and
  3. Sadasivan Chinniah2
  1. 1Foundation School, Northampton General Hospital NHS Trust, Northampton, UK
  2. 2Northampton General Hospital NHS Trust, Northampton, Northamptonshire, UK
  1. Correspondence to Dr Mariya Rajesh; mariyarajesh932{at}gmail.com

Abstract

A previously fit and well male in his early 40s, presented to the emergency department, hypotensive, bradycardic and hypothermic with reduced levels of consciousness after being found diaphoretic and unwell at his home. Despite fluid resuscitation with warmed saline, he remained hypotensive and required vasopressor support leading to intensive care admission. Initially, the patient was managed for suspected meningoencephalitis but was later found to have hypopituitarism leading to secondary hypothyroidism and adrenal insufficiency. Subsequent investigations revealed it is due to empty sella syndrome.

  • Endocrine system
  • Pituitary disorders

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Footnotes

  • Contributors MR, Primary Author. Identified the patient for the report, gathered data, wrote the initial report, gained consent from the patient and uploaded the report to BMJ. TO, Consultant Endocrinology. Provided information regarding the patient's treatment and is the patient's primary consultant. Helped adjust the case report from the endocrine perspective. SC, Consultant Intensive Care and Anaesthetics. Guided throughout the process, adjusted the case report and assisted in the writing. Both consultants have countersigned this report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.