Severe hypoglycemia in a diabetic patient with pituitary apoplexy: a case report.
Humans
Male
Pituitary Apoplexy
/ complications
Hypoglycemia
/ etiology
Middle Aged
Diabetes Mellitus, Type 2
/ complications
Sulfonylurea Compounds
/ therapeutic use
Hypopituitarism
/ complications
Hypoglycemic Agents
/ therapeutic use
Magnetic Resonance Imaging
Pituitary Neoplasms
/ complications
Hypophysectomy
Adenoma
/ complications
Hydrocortisone
/ therapeutic use
Blood Glucose
/ analysis
Case report
Hyponatremia
Pituitary apoplexy
Recurrent hypoglycemia
Journal
Journal of medical case reports
ISSN: 1752-1947
Titre abrégé: J Med Case Rep
Pays: England
ID NLM: 101293382
Informations de publication
Date de publication:
01 Aug 2024
01 Aug 2024
Historique:
received:
04
04
2024
accepted:
15
06
2024
medline:
1
8
2024
pubmed:
1
8
2024
entrez:
31
7
2024
Statut:
epublish
Résumé
Hypoglycemia is a common occurrence in diabetic patients. But unlike non diabetic patients, its causes are frequently related to drugs they are receiving to control blood glucose. But this may not always be the case. Here we report a type 2 diabetic patient with severe hypoglycemia owing to acute hypopituitarism secondary to pituitary apoplexy. A 45 year old male diabetic patient from Ethiopia taking 2 mg of oral glimepiride daily who presented with change in mentation of 30 minutes and blood glucose recording of 38 mg/dl upon arrival to the emergency room. Brain magnetic resonance imaging showed pituitary macroadenoma with hemorrhage suggestive of pituitary apoplexy. Blood work up showed low adrenocorticotropic hormone, cortisol, and serum sodium levels. Subsequently transsphenoidal hypophysectomy was done. The occurrence of hypoglycemia in a diabetic patient taking sulphonylurea monotherapy is common. But when it is severe enough to cause altered mentation, patients should be approached differently. In the presence of clinical clues suggesting cortisol deficiency, hypopituitarism can be a possible cause.
Identifiants
pubmed: 39085948
doi: 10.1186/s13256-024-04642-9
pii: 10.1186/s13256-024-04642-9
doi:
Substances chimiques
Sulfonylurea Compounds
0
Hypoglycemic Agents
0
glimepiride
6KY687524K
Hydrocortisone
WI4X0X7BPJ
Blood Glucose
0
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
349Informations de copyright
© 2024. The Author(s).
Références
Yale JF, Paty B, Senior PA. Hypoglycemia. Can J Diabetes. 2018;42:S104–8.
doi: 10.1016/j.jcjd.2017.10.010
pubmed: 29650081
Seaquist ER, Anderson J, Childs B, Cryer P, Dagogo-Jack S, Fish L, et al. Hypoglycemia and diabetes: a report of aworkgroup of the American diabetes association and the endocrine society. Diabetes Care. 2013;36(5):1384–95.
doi: 10.2337/dc12-2480
pubmed: 23589542
pmcid: 3631867
Geraghty AC, Kaufer D. Glucocorticoid signaling. Adv Exp Med Biol. 2015;872:253–78.
doi: 10.1007/978-1-4939-2895-8_11
pubmed: 26215998
Ranabir S, Baruah MP. Review article: pituitary apoplexy. Indian J Endocrinol Metab. 2011;15(Suppl 3):S188–96.
pubmed: 22029023
pmcid: 3183518
Briet C, Salenave S, Bonneville JF, Laws ER, Chanson P. Pituitary apoplexy. Endocr Rev. 2015;36(6):622–45.
doi: 10.1210/er.2015-1042
pubmed: 26414232
Schopman JE, Simon ACR, Hoefnagel SJM, Hoekstra JBL, Scholten RJPM, Holleman F. The incidence of mild and severe hypoglycaemia in patients with type 2 diabetes mellitus treated with sulfonylureas: a systematic review and meta-analysis. Diabetes Metab Res Rev. 2014;30(1):11–22.
doi: 10.1002/dmrr.2470
pubmed: 24030920
Balducci S, Sacchetti M, Haxhi J, Orlando G, D’Errico V, Fallucca S, Menini S, Pugliese G. Physical exercise as therapy for type II diabetes. Diabetes Metab Res Rev. 2014;32(30):13–23.
doi: 10.1002/dmrr.2514
Jessani N, Jehangir W, Behman D, Yousif A, Spiler IJ. Secondary adrenal insufficiency: an overlooked cause of hyponatremia. J Clin Med Res. 2015;7(4):286–8.
doi: 10.14740/jocmr2041w
pubmed: 25699130
pmcid: 4330026
Theoretical PI, By GIT, Yarrow RS. Downloaded from https://royalsocietypublishing.org/ on 14 March 2024 Downloaded from https://royalsocietypublishing.org/ on 14 March 2024. 1934;538(1932):362–87.
Graves ML. Clinical studies. South Med J. 1923;16(3):151–60.
doi: 10.1097/00007611-192303000-00001