Asymptomatic pituitary apoplexy induced by corticotropin-releasing hormone in a 14 year-old girl with Cushing’s disease
-
Liliana Fonseca
,
Diana Borges Duarte
Abstract
Objectives
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.
Case presentation
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.
Conclusions
To our knowledge, the authors report the first case of a pituitary apoplexy after a CRH stimulation test in the paediatric age.
Research funding: None declared.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Competing interests: Liliana Fonseca declares that she has no conflict of interest. Diana Borges Duarte declares that she has no conflict of interest. Joana Freitas declares that she has no conflict of interest. Maria João Oliveira declares that she has no conflict of interest. Isabel Ribeiro declares that she has no conflict of interest. Cláudia Amaral declares that she has no conflict of interest. Teresa Borges declares that she has no conflict of interest.
Ethics approval and consent to participate: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Documentation of informed consent, including written permission from the patient’s legal guardians prior to inclusion in the study was included.
Employment or leadership: None declared.
Honorarium: None declared.
Consent for publication: Liliana Fonseca assigns Journal of Pediatric Endocrinology and Metabolism all rights of copyright.
References
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Articles in the same Issue
- Frontmatter
- Review Article
- Provocative growth hormone testing in children: how did we get here and where do we go now?
- Original Articles
- Mental and somatic health in university students with type 1 diabetes: new results from DiaSHoT18, a cross sectional national health and well-being survey
- Prevalence of elevated liver enzymes and their association with type 2 diabetes risk factors in children
- What is the relationship between obesity and new circadian rhythm parameters in Turkish children and adolescents? A case-control study
- Body fat distribution in trunk and legs are associated with cardiometabolic risk clustering among Chinese adolescents aged 10–18 years old
- Is overweight/obesity a risk factor for atopic allergic disease in prepubertal children? A case–control study
- Importance of individualizing treatment decisions in girls with central precocious puberty when initiating treatment after age 7 years or continuing beyond a chronological age of 10 years or a bone age of 12 years
- Blood pressure dynamics after pubertal suppression with gonadotropin-releasing hormone analogs followed by estradiol treatment in transgender female adolescents: a pilot study
- Levels of physical activity and barriers to sport participation in young people with gender dysphoria
- Serum sclerostin concentration is associated with specific adipose, muscle and bone tissue markers in lean adolescent females with increased physical activity
- Validation of a continuous measure of cardiometabolic risk among adolescents
- Clinical characteristics and molecular genetic analysis of a cohort with idiopathic congenital hypogonadism
- The genetics and clinical manifestations of patients with vitamin D dependent rickets type 1A
- Switching from conventional therapy to burosumab injection has the potential to prevent nephrocalcinosis in patients with X-linked hypophosphatemic rickets
- Case Reports
- Asymptomatic pituitary apoplexy induced by corticotropin-releasing hormone in a 14 year-old girl with Cushing’s disease
- Two patients from Turkey with a novel variant in the GM2A gene and review of the literature
- Familial hyperphosphatemic tumoral calcinosis in an unusual and usual sites and dramatic improvement with the treatment of acetazolamide, sevelamer and topical sodium thiosulfate
- Pediatric diabetic ketoacidosis presenting with Streptococcus intermedius brain abscess
