Pituitary tuberculosis presented with pituitary coma

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Published Oct 25, 2018
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Vol. 96 No. 8 (2018): Issue Aug 2018

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Melika Chihaoui
Ibtissem Oueslati
Fatma Chaker
Meriem Yazidi
Ahmed Goubantini
Sonia Nagi
Hedia Slimane

Abstract

Background: pituitary tuberculosis is very rare. Its diagnosis is difficult unless a bacteriological or histological evidence of tuberculosis.
Case observation: we report the case of a 54 years old woman who presented with a pituitary coma that occurred two weeks after the initiation of antituberculous therapy for cervical lymph node tuberculosis. Resonance magnetic imaging showed a pseudotumoral aspect of the pituitary gland. She had hormonal replacement and anti-tuberculous therapy. Outcome was favourable with the normalization of both the pituitary function and the pituitary volume. However, an acute hypopituitarism happened eight months after the withdrawal of antituberculous, which were taken during 12 months. The re initiation of anti tuberculous therapy and its extension to two years leaded to a prolonged remission. 
Conclusion: the three-phase outcome confirms the tuberculous origin of the hypophysitis in our patient.

Keywords:

Pituitary coma; enzyme inducer; hypopituitarism; pituitary tuberculosis.

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