RT Journal Article
SR Electronic
T1 Lesson of the month 2: Houssay phenomenon – hypopitutarism leading to remission of diabetes
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 294
OP 296
DO 10.7861/clinmedicine.16-3-294
VO 16
IS 3
A1 Subhodip Pramanik
A1 Rana Bhattacharjee
A1 Pradip Mukhopadhyay
A1 Sujoy Ghosh
YR 2016
UL http://www.rcpjournals.org/content/16/3/294.abstract
AB Because of a pituitary insult and the subsequent loss of counter-regulatory hormones, individuals can experience increased sensitivity to insulin, hypoglycaemia or even complete amelioration of diabetes; this is known as the Houssay phenomenon. Severe dehydration following diarrhoea can lead to pituitary infarction causing hypopituitarism. We describe this situation in a patient with insulin-treated type-2 diabetes presenting with recurrent hypoglycaemia and cessation of insulin requirement along with weight loss, hypotension and hyponatraemia. Pituitary imaging revealed a partial empty sella and a synacthen stimulation test revealed an initial positive response but later loss of response, proving recent-onset pituitary dysfunction. Physicians should keep this possibility in mind while treating hypoglycaemia in stable diabetic individuals. Judicious supplementation of deficient hormones is of utmost importance.