January - March 2012, Volume 8, Issue 1

Chentli F, Terki B, Djerradi L, Belhimer F, Azzoug S

Cure of Acromegaly and Diabetes Mellitus After Pituitary Apoplexy

Acta Endo (Buc) 2012, 8 (1): 113-118
doi: 10.4183/aeb.2012.113

Introduction. Pituitary apoplexy is a rare, acute, and life threatening condition due to haemorrhage or necrosis within a pituitary adenoma. Its prognosis may be poor leading to a fatal issue, or be good inducing a decrease or cure of the pituitary adenoma as in the case presented.\r\nCase report. A man, aged 28 years, having a history of well proved acromegaly [Growth hormone =GH=205ng/mL (n<5),\r\nand pituitary adenoma measuring 19x16mm] with diabetes mellitus (Glycaemia 4g/L, glycosuria++++, with ketoacidosis) treated with insulin for one year, was referred for\r\nnumerous hypoglycaemias which obliged him to stop insulin and diet. Just before, he had an acute episode of headaches, nauseas and vomiting. Clinical exam showed typical\r\nacromegaly, but pituitary assessment demonstrated low GH=0.05ng/mL, normal IGF1, without pituitary deficits. Routine analyses were normal. Fasting glycaemias, and glycaemias after glucose loading were normal too. Cerebral MRI showed a significant decrease in pituitary tumour (10 x\r\n16mm). Ten years later, glycaemias, GH, IGF1, and other pituitary functions remained normal, the necrotic pituitary process decreased up to 4.5 mm in height.\r\nConclusion. This clinical history and outcome argued for a pituitary apoplexy secondary to apparently spontaneous\r\nnecrosis of a somatotrop adenoma that induced a total cure of acromegaly and diabetes mellitus.

Keywords: pituitary apoplexy, cure of acromegaly, cure of diabetes mellitus.

Correspondence: Farida Chentli, Bab El Oued Hospital - Endocrine and Metabolic Diseases, 5 Boulevard Said Touati Algiers 16000, Algeria, T: 0021321960040 Email: endofarida@hotmail.fr