Pituitary apoplexy medical therapy: Difference between revisions
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{{Pituitary apoplexy}} | {{Pituitary apoplexy}} | ||
{{CMG}} {{AE}} {{Akshun}} | {{CMG}} {{AE}} {{Akshun}} | ||
==Overview== | |||
The optimal [[therapy]] for pituitary apoplexy depends upon the presentationn of the [[patient]]. The emphasis is on early [[hemodynamic]] stabilization of the patient, with evaluation for [[signs]] of [[Pituitary hormone|pituitary hormones]] deficiency. Life threatening [[hypopituitarism]] must be treated with replacement of [[hormones]]. | |||
==Medical Therapy== | ==Medical Therapy== | ||
Medical treatment consists of | [[Medical treatment]] consists of:<ref name="pmid6785084">{{cite journal |vauthors=Veldhuis JD, Hammond JM |title=Endocrine function after spontaneous infarction of the human pituitary: report, review, and reappraisal |journal=Endocr. Rev. |volume=1 |issue=1 |pages=100–7 |year=1980 |pmid=6785084 |doi=10.1210/edrv-1-1-100 |url=}}</ref><ref name="pmid8815944">{{cite journal |vauthors=Oelkers W |title=Adrenal insufficiency |journal=N. Engl. J. Med. |volume=335 |issue=16 |pages=1206–12 |year=1996 |pmid=8815944 |doi=10.1056/NEJM199610173351607 |url=}}</ref><ref name="pmid27668187">{{cite journal |vauthors=De Ycaza AE, Chang AY, Jensen JR, Khan Z, Erickson D |title=Approach to the management of rare clinical presentations of macroprolactinomas in reproductive-aged women |journal=Case Rep Womens Health |volume=8 |issue= |pages=9–12 |year=2015 |pmid=27668187 |pmc=5033506 |doi=10.1016/j.crwh.2015.09.001 |url=}}</ref> | ||
* Hemodynamic | * [[Hemodynamics|Hemodynamic]] stabilization of the [[patient]] with evaluation for [[signs]] of [[pituitary hormone]]<nowiki/>s deficiency and [[electrolyte]] abnormalities. | ||
* Most patients have life threatening hypopituitarism. Replace hormones with | * Most patients have life threatening [[hypopituitarism]]. Replace [[hormones]] with: | ||
**High-dose [[corticosteroids]] | **High-dose [[corticosteroids]] | ||
**[[Sex hormones]] ([[estrogen]]/[[testosterone]]) | **[[Sex hormones]] ([[estrogen]]/[[testosterone]]) | ||
**[[Thyroid hormone]] | **[[Thyroid hormone]] | ||
Evidence is also growing for the need to replace [[growth hormone]]. | *Evidence is also growing for the need to replace [[growth hormone]]. | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category:Endocrinology]] | [[Category:Endocrinology]] | ||
[[Category:Neurology]] | [[Category:Neurology]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Medicine]] | |||
[[Category:Up-To-Date]] | |||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Latest revision as of 16:26, 18 October 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]
Overview
The optimal therapy for pituitary apoplexy depends upon the presentationn of the patient. The emphasis is on early hemodynamic stabilization of the patient, with evaluation for signs of pituitary hormones deficiency. Life threatening hypopituitarism must be treated with replacement of hormones.
Medical Therapy
Medical treatment consists of:[1][2][3]
- Hemodynamic stabilization of the patient with evaluation for signs of pituitary hormones deficiency and electrolyte abnormalities.
- Most patients have life threatening hypopituitarism. Replace hormones with:
- High-dose corticosteroids
- Sex hormones (estrogen/testosterone)
- Thyroid hormone
- Evidence is also growing for the need to replace growth hormone.
References
- ↑ Veldhuis JD, Hammond JM (1980). "Endocrine function after spontaneous infarction of the human pituitary: report, review, and reappraisal". Endocr. Rev. 1 (1): 100–7. doi:10.1210/edrv-1-1-100. PMID 6785084.
- ↑ Oelkers W (1996). "Adrenal insufficiency". N. Engl. J. Med. 335 (16): 1206–12. doi:10.1056/NEJM199610173351607. PMID 8815944.
- ↑ De Ycaza AE, Chang AY, Jensen JR, Khan Z, Erickson D (2015). "Approach to the management of rare clinical presentations of macroprolactinomas in reproductive-aged women". Case Rep Womens Health. 8: 9–12. doi:10.1016/j.crwh.2015.09.001. PMC 5033506. PMID 27668187.