Endocrine disease in pregnancy
Editor – I read with interest the excellent update on endocrine disease in pregnancy (Clin Med April 2013 pp179–81). I write to draw your attention to an often neglected pituitary emergency: pituitary apoplexy.
Pituitary apoplexy is a potentially life threatening medical emergency. Pregnancy is mentioned by Frise and Williamson as a possible cause of pituitary insufficiency. However, pregnancy and the immediate post-pregnancy period is a predisposing factor for pituitary apoplexy as a pre-existing pituitary adenoma may haemorrhage or infarct (eg, postpartum Sheehan's syndrome).
This would then lead to acute pituitary insufficiency requiiring immediate recognition of this presentation and urgent replacement with hydrocortisone and other pituitary hormones. Patients often present with headaches, vomiting, hypotension and can suffer with visual loss or ophtalmoplegia. It is recommended that patients are urgently referred to a joint pituitary (endocrine & neurosurgery) clinic.
I would be grateful if you could draw your readers attention to the national guidelines on pituitary apoplexy.1
Footnotes
Please submit letters for the editor's consideration within three weeks of receipt of Clinical Medicine. Letters should ideally be limited to 350 words, and sent by email to: clinicalmedicine{at}rcplondon.ac.uk
- © 2013 Royal College of Physicians
Article Tools
Citation Manager Formats
Jump to section
Related Articles
- No related articles found.
Cited By...
- No citing articles found.