Publication

Hyponatremia associated coma due to pituitary apoplexy in early pregnancy: a case report

Journal Paper/Review - Mar 1, 2010

Units
PubMed

Citation
Krull I, Christ E, Kamm C, Ganter C, Sahli R. Hyponatremia associated coma due to pituitary apoplexy in early pregnancy: a case report. Gynecol Endocrinol 2010; 26:197-200.
Type
Journal Paper/Review (English)
Journal
Gynecol Endocrinol 2010; 26
Publication Date
Mar 1, 2010
Issn Electronic
1473-0766
Pages
197-200
Brief description/objective

Pituitary apoplexy in pregnancy is rare. Its clinical features may range from unspecific complaints to panhypopituitarism resulting even in coma and death. Therefore, alertness to signs and symptoms of acute loss of pituitary function in pregnancy is mandatory. We report a woman in her 7th week of her first gestation presenting with sudden coma due to severe hyponatremia. Secondary adrenal insufficiency could be identified as the underlying cause. Panhypopituitarism including central diabetes insipidus and spontaneous abortion developed during the follow-up. Magnetic resonance imaging showed pituitary apoplexy without a pre-existing pituitary mass. The clinical course was notable for severe complications, including neurological deficits through cerebral ischemia, but eventual recovery could be achieved. We discuss the diagnostic difficulties in the evaluation of pituitary disease in pregnancy.