{"title":"Postpartum pituitary necrosis and hypopituitarism, a sequela of severe falciparum malaria in pregnancy - a case report.","authors":"Moeez Ahmed, Shahid Ahmed","doi":"10.47391/JPMA.20214","DOIUrl":null,"url":null,"abstract":"<p><p>A 37 year old woman presented with a history of weakness and lethargy for many years. She had been amenorrhoeic for 5 years after a still birth at 37 weeks gestation, due to severe falciparum malaria. On examination, she appeared pale and lethargic, with a blood pressure of 100/70 mm Hg. Her systemic examination was unremarkable. Laboratory tests revealed low 9.00 am serum ACTH and cortisol levels, along with low free T4, FSH and LH levels. A short synacthen test showed an inadequate cortisol response at 30 minutes. MRI of the Pituitary gland displayed an empty sella. She was diagnosed with hypopituitarism due to postpartum pituitary necrosis, and was treated with hydrocortisone, thyroxine and sex hormone replacement therapy. The patient showed an excellent response to treatment.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 2","pages":"317-318"},"PeriodicalIF":0.8000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the Pakistan Medical Association","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.47391/JPMA.20214","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
A 37 year old woman presented with a history of weakness and lethargy for many years. She had been amenorrhoeic for 5 years after a still birth at 37 weeks gestation, due to severe falciparum malaria. On examination, she appeared pale and lethargic, with a blood pressure of 100/70 mm Hg. Her systemic examination was unremarkable. Laboratory tests revealed low 9.00 am serum ACTH and cortisol levels, along with low free T4, FSH and LH levels. A short synacthen test showed an inadequate cortisol response at 30 minutes. MRI of the Pituitary gland displayed an empty sella. She was diagnosed with hypopituitarism due to postpartum pituitary necrosis, and was treated with hydrocortisone, thyroxine and sex hormone replacement therapy. The patient showed an excellent response to treatment.
一位37岁的女性，表现出虚弱和昏睡多年的历史。由于严重的恶性疟疾，她在妊娠37周死产后闭经5年。检查时，患者面色苍白，嗜睡，血压100/70 mm Hg，全身检查无明显异常。实验室检查显示上午9点血清ACTH和皮质醇水平较低，游离T4、FSH和LH水平也较低。短暂的synacthen测试显示30分钟时皮质醇反应不足。脑下垂体核磁共振显示空蝶鞍。她因产后垂体坏死被诊断为垂体功能低下，并给予氢化可的松、甲状腺素和性激素替代治疗。病人对治疗反应很好。
期刊介绍：
Primarily being a medical journal, JPMA publishes scholarly research focusing on the various fields in the areas of health and medical education. It publishes original research describing recent advances in health particularly clinical studies, clinical trials, assessments of pathogens of diagnostic importance, medical genetics and epidemiological studies. Review articles highlighting importance of various issues in the domain of public health, drug research and medical education are also accepted. As a leading journal of South Asia, JPMA remains cognizant of the recent advances in the rapidly growing fields of biomedical sciences, it invites and encourages scholars to write short reviews and invited editorials on the emerging issues. We particularly aim to promote health standards of developing countries by encouraging manuscript submissions on issues affecting the public health and health delivery services.
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