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Gitelman's syndrome with panhypopituitarism: Reno-endocrine interplay.

Upreti V, Sharda C, Kumar BV, Dhull P, Prakash MS - Indian J Endocrinol Metab (2012)

Bottom Line: Recently few cases have been described having an association of Gitelman's syndrome with pituitary abnormalities on imaging, though with normal hormonal status.We describe the first case of an adult patient having Gitelman's syndrome and hypopituitarism with abnormal pituitary imaging.She presented to us with hypotension, hypokalemia, hypomagnesemia with alkalosis, hypothyroidism, hypocortisolism, and hypogonadism.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrinology, Command Hospital (Air Force), Bangalore, India.

ABSTRACT
Gitelman's syndrome is an inherited tubulopathy affecting thiazide-sensitive sodium chloride cotransporter, which manifests with hypokalemic alkalosis, hypomagnesemia, and hypocalciuria. Recently few cases have been described having an association of Gitelman's syndrome with pituitary abnormalities on imaging, though with normal hormonal status. We describe the first case of an adult patient having Gitelman's syndrome and hypopituitarism with abnormal pituitary imaging. She presented to us with hypotension, hypokalemia, hypomagnesemia with alkalosis, hypothyroidism, hypocortisolism, and hypogonadism. She was treated with replacement of electrolytes and hormones, to which she showed an excellent response.

No MeSH data available.


Related in: MedlinePlus

MRI sella (sagittal view) showing loss of posterior pituitary bright spot
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Figure 1: MRI sella (sagittal view) showing loss of posterior pituitary bright spot

Mentions: Thyroid profile at baseline was suggestive of hypothyroidism [low T4, thyroid stimulating hormone (TSH) 9.06 μU/l], whereas it was normal at presentation. There was hypocortisolism (random plasma cortisol: 164 nmol/l and peak cortisol during insulin-induced hypoglycemia: 453.2 nmol/l), relatively normal adrenocorticotropic hormone (ACTH) 11.6 pg/ml (7.2–63.3), and low gonadotropins [luteinizing hormone (LH) 1.36 mIU/ml, follicle stimulating hormone (FSH) 4.00 mIU/ml]. Serum prolactin [5.8 ng/ ml (5–25)] and serum insulin-like growth factor 1 (IGF-1) [156 ng/ml (66–310)] were low normal. Peak growth hormone level after IIH was 5.6 ng/ml. Anti-thyroid peroxide antibody levels were normal. MRI sella showed loss of posterior pituitary bright spot [Figure 1]; however, anterior pituitary was normal.


Gitelman's syndrome with panhypopituitarism: Reno-endocrine interplay.

Upreti V, Sharda C, Kumar BV, Dhull P, Prakash MS - Indian J Endocrinol Metab (2012)

MRI sella (sagittal view) showing loss of posterior pituitary bright spot
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3313754&req=5

Figure 1: MRI sella (sagittal view) showing loss of posterior pituitary bright spot
Mentions: Thyroid profile at baseline was suggestive of hypothyroidism [low T4, thyroid stimulating hormone (TSH) 9.06 μU/l], whereas it was normal at presentation. There was hypocortisolism (random plasma cortisol: 164 nmol/l and peak cortisol during insulin-induced hypoglycemia: 453.2 nmol/l), relatively normal adrenocorticotropic hormone (ACTH) 11.6 pg/ml (7.2–63.3), and low gonadotropins [luteinizing hormone (LH) 1.36 mIU/ml, follicle stimulating hormone (FSH) 4.00 mIU/ml]. Serum prolactin [5.8 ng/ ml (5–25)] and serum insulin-like growth factor 1 (IGF-1) [156 ng/ml (66–310)] were low normal. Peak growth hormone level after IIH was 5.6 ng/ml. Anti-thyroid peroxide antibody levels were normal. MRI sella showed loss of posterior pituitary bright spot [Figure 1]; however, anterior pituitary was normal.

Bottom Line: Recently few cases have been described having an association of Gitelman's syndrome with pituitary abnormalities on imaging, though with normal hormonal status.We describe the first case of an adult patient having Gitelman's syndrome and hypopituitarism with abnormal pituitary imaging.She presented to us with hypotension, hypokalemia, hypomagnesemia with alkalosis, hypothyroidism, hypocortisolism, and hypogonadism.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrinology, Command Hospital (Air Force), Bangalore, India.

ABSTRACT
Gitelman's syndrome is an inherited tubulopathy affecting thiazide-sensitive sodium chloride cotransporter, which manifests with hypokalemic alkalosis, hypomagnesemia, and hypocalciuria. Recently few cases have been described having an association of Gitelman's syndrome with pituitary abnormalities on imaging, though with normal hormonal status. We describe the first case of an adult patient having Gitelman's syndrome and hypopituitarism with abnormal pituitary imaging. She presented to us with hypotension, hypokalemia, hypomagnesemia with alkalosis, hypothyroidism, hypocortisolism, and hypogonadism. She was treated with replacement of electrolytes and hormones, to which she showed an excellent response.

No MeSH data available.


Related in: MedlinePlus