Amelioration of acromegaly after pituitary infarction due to gastrointestinal hemorrhage from gastric ulcer.

We report a rare case of acromegaly in which pituitary infarction possibly developed in a GH-producing pituitary adenoma following gastrointestinal bleeding from peptic ulcer. In this case, pituitary infarction resulted in spontaneous remission of acromegaly associated with diabetes mellitus. In addition, detailed histological investigation revealed that clinically silent pituitary apoplexy was mainly an acute ischemic event which occurred recently in a GH-producing adenoma. This event led to massive coagulation necrosis of the tumor and endocrinological improvement.

[1]  M. Vassallo,et al.  Pituitary apoplexy after stimulation tests. , 1994, Postgraduate medical journal.

[2]  L. Laine.  Upper gastrointestinal tract hemorrhage. , 1991, The Western journal of medicine.

[3]  T. Wisniewski,et al.  Clinical versus subclinical pituitary apoplexy: presentation, surgical management, and outcome in 21 patients. , 1990, Neurosurgery.

[4]  N. Tamasawa,et al.  Spontaneous remission of acromegaly after pituitary apoplexy following head trauma , 1988, Journal of endocrinological investigation.

[5]  S. Yen,et al.  Pituitary apoplexy. A review. , 1985, Archives of neurology.

[6]  N. Jones,et al.  Pituitary infarction and development of the empty sella syndrome after gastrointestinal haemorrhage. , 1984, British medical journal.

[7]  S. Wakai,et al.  Pituitary apoplexy: its incidence and clinical significance. , 1981, Journal of neurosurgery.

[8]  D. Aron,et al.  Silent pituitary apoplexy: subclinical infarction of an adrenocorticotropin-producing pituitary adenoma. , 1981, The Journal of clinical endocrinology and metabolism.

[9]  J. Hammond,et al.  Endocrine function after spontaneous infarction of the human pituitary: report, review, and reappraisal. , 1980, Endocrine reviews.

[10]  A. Aro,et al.  Pituitary function after pituitary apoplexy. , 1978, The American journal of medicine.

[11]  A. Lawrence,et al.  Hypothalamic hypopituitarism after pituitary apoplexy in acromegaly. , 1977, Archives of internal medicine.

[12]  E. Lufkin,et al.  Acute cerebral dysfunction in diabetic ketoacidosis: survivial followed by panhypopituitarism. , 1977, Metabolism: clinical and experimental.

[13]  M. Taskinen,et al.  Insulin deficiency associated with hypoglycemia and good glucose tolerance in hypopituitarism. Report of a case with acromegaly developing pituitary apoplexy. , 2009, Acta medica Scandinavica.

[14]  R. Daroff,et al.  Pituitary apoplexy in acromegaly followed by partial pituitary insufficiency. , 1974, Archives of internal medicine.

[15]  R. D. Adams,et al.  Acute degenerative changes in adenomas of the pituitary body--with special reference to pituitary apoplexy. , 1950, Journal of neurosurgery.

[16]  H. Sheehan,et al.  Post‐partum Necrosis of the Anterior Pituitary; Pathological and Clinical Aspects , 1938 .