ABSTRACT
Pituitary tumor can be accompanied with various pituitary hormone abnormalities. Pituitary tumors can be divided into functioning or nonfunctioning tumors. A functioning pituitary tumor, via the oversecretion of pituitary hormones, causes diverse clinical features. A nonfunctioning pituitary tumor can be accompanied with pituitary dysfunction and this may be due to compression or destruction of normal pituitary tissue, suppression of the pituitary portal system or direct damage to the hypothalamus. Corticotropin-releasing hormone (CRH) deficiency, which is caused by defects in the synthesis or release of CRH, is a cause of secondary adrenocortical insufficiency. The clinical presentations are hypoglycemia, weight loss, anemia, weakness, nausea, vomiting and hyponatremia. Acquired CRH deficiency has also been suggested to occur based on a lack of adrenocorticotropic hormone (ACTH) response to insulin-induced hypoglycemia, but there is a normal ACTH response to exogenous CRH. We experienced a case of a woman with pituitary macroadenoma accompanied with CRH deficiency. We report here on this case with the review of the literature.
Subject(s)
Female , Humans , Adrenocorticotropic Hormone , Anemia , Corticotropin-Releasing Hormone , Hypoglycemia , Hyponatremia , Hypothalamus , Nausea , Pituitary Hormones , Pituitary Neoplasms , Portal System , Vomiting , Weight LossABSTRACT
Most cases of superior vena cava (SVC) syndrome are secondary to malignant disease and subacute in their presentation. However, the exponential increase in use of indwelling central venous catheters and cardiac pacemakers over the last two decades has resulted in more patients with SVC syndrome. Internal jugular vein cannulation has become the preferred approach for temporary hemodialysis catheter placement following the reports of an increased incidence of subclavian vein stenosis due to subclavian vein catheterization. We describe a patient who developed SVC syndrome after internal jugular vein catheterization. The patient had been swollen the left arm intermittently due to left central vein stenosis for 1 year and experienced balloon angioplasty and stent insertion for three times. We diagnosed the SVC syndrome through the both subclavian venography, which revealed complete obstruction of the left brachiocephalic vein with extensive collateral circulation and mild stenosis of the distal right internal jugular vein. Resolution of the clinical SVC sydrome occurred after catheter removal.
Subject(s)
Humans , Angioplasty, Balloon , Arm , Brachiocephalic Veins , Catheterization , Catheters , Central Venous Catheters , Collateral Circulation , Constriction, Pathologic , Incidence , Jugular Veins , Phlebography , Renal Dialysis , Stents , Subclavian Vein , Superior Vena Cava Syndrome , Veins , Vena Cava, SuperiorABSTRACT
Most cases of superior vena cava (SVC) syndrome are secondary to malignant disease and subacute in their presentation. However, the exponential increase in use of indwelling central venous catheters and cardiac pacemakers over the last two decades has resulted in more patients with SVC syndrome. Internal jugular vein cannulation has become the preferred approach for temporary hemodialysis catheter placement following the reports of an increased incidence of subclavian vein stenosis due to subclavian vein catheterization. We describe a patient who developed SVC syndrome after internal jugular vein catheterization. The patient had been swollen the left arm intermittently due to left central vein stenosis for 1 year and experienced balloon angioplasty and stent insertion for three times. We diagnosed the SVC syndrome through the both subclavian venography, which revealed complete obstruction of the left brachiocephalic vein with extensive collateral circulation and mild stenosis of the distal right internal jugular vein. Resolution of the clinical SVC sydrome occurred after catheter removal.