Clinical case of 24 years old woman with panhypopituitarism

• Irina S. Chernysheva

Abstract

A 24 year old woman was referred because of hypoglycemia. The woman had always been short and thin for her age. At the age of 15, she consulted a gynecologist for primary amenorrhea, but no diagnosis or treatment was prescribed for 5 years. It was only at the age of 20 that an examination was scheduled for the first time: MRI revealed a mass in the parasellar region with compression of the pituitary gland and chiasm. Then surgical treatment was performed and replacement therapy for hypothyroidism and hypocorticism was prescribed. Physical examination showed: proportional development, body mass index 17,9 kg/m², prepubertal stage according to Tanner. Laboratory investigations showed hormone levels consistent with hypogonadism. Computed tomography of the chest organs showed focal pneumonia and osteoporosis. This clinical case shows the consequences of both the lack of hormone replacement therapy for hypogonadism and the lack of awareness of patients about the possible development of acute adrenal insufficiency and relief of this condition.

Keywords:panhypopituitarism; hypogonadism; osteoporosis; acute adrenal insufficiency; craniopharyngioma