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Case Reports
. 2021 Jul 28;14(7):e243607.
doi: 10.1136/bcr-2021-243607.

Apoplexy in a previously undiagnosed pituitary macroadenoma in the setting of recent COVID-19 infection

Su-Yi Liew  1 , Rachel Seese  1 , Abdulrahman Shames  2 , Kalpita Majumdar  3
Affiliations
Case Reports

Apoplexy in a previously undiagnosed pituitary macroadenoma in the setting of recent COVID-19 infection

Su-Yi Liew et al. BMJ Case Rep. .

Abstract

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.

Keywords: COVID-19; endocrinology; pituitary disorders.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Sagittal reformat of CT scan showing high attenuation mass in pituitary fossa (large arrow). Note that a low attenuation artefact due to beam hardening from adjacent bone obscures the anteroinferior portion of the pituitary fossa (small arrow).
Figure 2
Figure 2
Unenhanced (left) and contrast-enhanced (right) T1-weighted sagittal MRI scans demonstrate an area of high signal within the enlarged pituitary gland due to methaemoglobin (large arrow) and a smaller crescentic area of the haematoma at a different stage of evolution (small arrow). There is normal enhancement of the compressed pituitary tissue and pituitary stalk (paired arrows right image).
Figure 3
Figure 3
Follow-up T1-weighted sagittal MRI scan demonstrates reduction in size of the haematoma with change in superior aspect of pituitary gland from convex to concave (arrow).
See this image and copyright information in PMC

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