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BMJ Case Rep ; 14(7)2021 Jul 28.
Article in English | MEDLINE | ID: covidwho-1331803


Pituitary apoplexy is an endocrine emergency, which commonly presents as hypopituitarism. Prompt diagnosis and treatment can be both life and vision saving. There are a growing number of published case reports postulating a link between COVID-19 and pituitary apoplexy. We report the case of a 75-year-old man who presented with a headache and was later diagnosed with hypopituitarism secondary to pituitary apoplexy. This occurred 1 month following a mild-to-moderate COVID-19 infection with no other risk factors commonly associated with pituitary apoplexy. This case, therefore, supplements an emerging evidence base supporting a link between COVID-19 and pituitary apoplexy.

Adenoma , COVID-19 , Pituitary Apoplexy , Pituitary Neoplasms , Stroke , Adenoma/complications , Adenoma/diagnosis , Aged , Humans , Male , Pituitary Apoplexy/diagnosis , Pituitary Apoplexy/etiology , Pituitary Neoplasms/complications , Pituitary Neoplasms/diagnosis , SARS-CoV-2
Front Endocrinol (Lausanne) ; 12: 596654, 2021.
Article in English | MEDLINE | ID: covidwho-1167312


In early 2020, a novel coronavirus leading to potentially death was discovered. Since then, the 2019 coronavirus disease (COVID-19) has spread to become a worldwide pandemic. Beyond the risks strictly related to the infection, concerns have been expressed for the endocrinological impact that COVID-19 may have, especially in vulnerable individuals with pre-existing endocrinological health conditions. To date new information is emerging regarding severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) in children but the literature is still scarce concerning this infection in patients with intracranial malignant neoplasms. We report a 9-year-old child infected with SARS-CoV-2 and recent diagnosis of suprasellar non-germinomatous germ cell tumor also suffering from diabetes insipidus and hypothalamic-pituitary failure (hypothyroidism, adrenal insufficiency, hypothalamic obesity and growth hormone deficiency) and its clinical course. The patient remained asymptomatic for the duration of the infection without requiring any change in the replacement therapeutic dosages taken before the infection. We then discuss the proposed approach to treat a pediatric patient with SARS-CoV-2 infection and hypothalamic-pituitary failure and we include a review of the literature. Our report suggests that SARS-CoV-2 infection is usually mild and self-limiting in children even those immunocompromised and with multiple endocrinological deficits. Patients are advised to keep any scheduled appointments unless informed otherwise.

COVID-19/complications , Hypothalamo-Hypophyseal System/physiopathology , Neoplasms, Germ Cell and Embryonal/complications , Neoplasms, Germ Cell and Embryonal/therapy , Pituitary Neoplasms/complications , Pituitary Neoplasms/therapy , COVID-19/physiopathology , COVID-19/therapy , Child , Diabetes Insipidus/complications , Diabetes Insipidus/physiopathology , Female , Humans , Magnetic Resonance Imaging , Neoplasms, Germ Cell and Embryonal/physiopathology , Pituitary Neoplasms/physiopathology , Quarantine , Stem Cell Transplantation
Neurosurgery ; 87(2): E140-E146, 2020 08 01.
Article in English | MEDLINE | ID: covidwho-71966


BACKGROUND AND IMPORTANCE: A pituitary adenoma patient who underwent surgery in our department was diagnosed with COVID-19 and 14 medical staff were confirmed infected later. This case has been cited several times but without accuracy or entirety, we feel obligated to report it and share our thoughts on the epidemic among medical staff and performing endonasal endoscopic surgery during COVID-19 pandemic. CLINICAL PRESENTATION: The patient developed a fever 3 d post endonasal endoscopic surgery during which cerebrospinal leak occurred, and was confirmed with SARS-CoV-2 infection later. Several medical staff outside the operating room were diagnosed with COVID-19, while the ones who participated in the surgery were not. CONCLUSION: The deceptive nature of COVID-19 results from its most frequent onset symptom, fever, a cliché in neurosurgery, which makes it hard for surgeons to differentiate. The COVID-19 epidemic among medical staff in our department was deemed as postoperative rather than intraoperative transmission, and attributed to not applying sufficient personal airway protection. Proper personal protective equipment and social distancing between medical staff contributed to limiting epidemic since the initial outbreak. Emergency endonasal endoscopic surgeries are feasible since COVID-19 is still supposed to be containable when the surgeries are performed in negative pressure operating rooms with personal protective equipment and the patients are kept under quarantine postoperatively. However, we do not encourage elective surgeries during this pandemic, which might put patients in conditions vulnerable to COVID-19.

Adenoma/surgery , Coronavirus Infections/transmission , Infectious Disease Transmission, Patient-to-Professional/statistics & numerical data , Neuroendoscopy/methods , Pituitary Neoplasms/surgery , Pneumonia, Viral/transmission , Adenoma/complications , Aged , Betacoronavirus , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Elective Surgical Procedures , Epidemics , Humans , Lung/diagnostic imaging , Male , Nasal Cavity , Natural Orifice Endoscopic Surgery , Neurosurgical Procedures/methods , Operating Rooms , Pandemics , Patient Isolation , Pituitary Neoplasms/complications , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Postoperative Care , SARS-CoV-2 , Tomography, X-Ray Computed