Generic placeholder image

Endocrine, Metabolic & Immune Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

Case Report

Characteristics of Patients with Hypopituitarism having Onset Symptoms of Pseudo-Intestinal Obstruction: A Case Report

Author(s): Ning Yuan, Sanbao Chai, Jianbin Sun, Yufang Liu, Sixu Xin and Xiaomei Zhang*

Volume 21, Issue 2, 2021

Published on: 06 May, 2020

Page: [360 - 364] Pages: 5

DOI: 10.2174/1871530320666200506075958

Price: $65

Abstract

Background: Gastrointestinal symptoms are often the first symptoms of hypopituitarism. However, pseudo-intestinal obstruction is not a common manifestation of hypopituitarism. Some patients presenting with gastrointestinal symptoms as their chief complaint were admitted to the Department of Gastroenterology and were accurately diagnosed with hypopituitarism at the Department of Endocrinology.

Case Summary: This case pertains to a 57-year-old man with poor appetite, fatigue, weakness, and recent onset recurring abdominal pain. An erect, abdominal X-ray indicated flatulence and gas-fluid levels in the midsection of the abdomen, and pseudo-intestinal obstruction was diagnosed. Subsequently, the patient was referred to the Department of Gastroenterology to identify the cause of the pseudo-intestinal obstruction. An examination of the digestive system did not reveal any abnormalities, but the patient developed hyponatremia and exhibited drowsiness. The patient was transferred to the Department of Endocrinology for further treatment. The patient was eventually diagnosed with hypopituitarism, caused by empty sella syndrome. The patient received prednisone and euthyrox replacement therapy, and pseudo-intestinal obstruction did not occur again.

Conclusion: In general, endocrine diseases, including hypopituitarism, hypothyroidism, and hyponatremia, should be considered for patients with pseudo-intestinal obstruction combined with hyponatremia and drowsiness, especially if the symptoms of the digestive system are not complicated and the drowsiness is obvious.

Keywords: Hypopituitarism, pseudo-intestinal obstruction, empty sella syndrome, gastrointestinal symptoms, hypothyroidism, hyponatremia.

Graphical Abstract
[1]
Kurtoğlu, S.; Özdemir, A.; Hatipoğlu, N. Neonatal hypopituitarism: approaches to diagnosis and treatment. J. Clin. Res. Pediatr. Endocrinol., 2019, 11(1), 4-12.
[http://dx.doi.org/10.4274/jcrpe.galenos.2018.2018.0036] [PMID: 29739730]
[2]
Li, X.; Yang, H.; Duan, Z.; Chang, Q.; Wei, X.; Li, C.; Ba, Y.; Du, J. A case series study of hypopituitarism in older patients with and without gastrointestinal symptoms. Postgrad. Med., 2018, 130(5), 501-506.
[http://dx.doi.org/10.1080/00325481.2018.1479612] [PMID: 29863435]
[3]
Rodrigo, C.; Gamakaranage, C.S.; Epa, D.S.; Gnanathasan, A.; Rajapakse, S. Hypothyroidism causing paralytic ileus and acute kidney injury - case report. Thyroid Res., 2011, 4(1), 7.
[http://dx.doi.org/10.1186/1756-6614-4-7] [PMID: 21303532]
[4]
Toogood, A.A.; Stewart, P.M. Hypopituitarism: clinical features, diagnosis, and management. Endocrinol. Metab. Clin. North Am., 2008, 37(1), 235-261.
[http://dx.doi.org/10.1016/j.ecl.2007.10.004] [PMID: 18226739]
[5]
Rudolph, C.D.; Hyman, P.E.; Altschuler, S.M.; Christensen, J.; Colletti, R.B.; Cucchiara, S.; Di Lorenzo, C.; Flores, A.F.; Hillemeier, A.C.; McCallum, R.W.; Vanderhoof, J.A. Diagnosis and treatment of chronic intestinal pseudo-obstruction in children: report of consensus workshop. J. Pediatr. Gastroenterol. Nutr., 1997, 24(1), 102-112.
[http://dx.doi.org/10.1097/00005176-199701000-00021] [PMID: 9093995]
[6]
El-Chammas, K.; Sood, M.R. Chronic intestinal pseudo-obstruction. Clin. Colon Rectal Surg., 2018, 31(2), 99-107.
[http://dx.doi.org/10.1055/s-0037-1609024] [PMID: 29487492]
[7]
Bastenie, P.A. Paralytic ileus in severe hypothyroidism. Lancet, 1946, 1(6395), 413-416.
[http://dx.doi.org/10.1016/S0140-6736(46)90364-9] [PMID: 21019216]
[8]
Wells, I.; Smith, B.; Hinton, M. Acute ileus in myxoedema. BMJ, 1977, 1(6055), 211-212.
[http://dx.doi.org/10.1136/bmj.1.6055.211-a] [PMID: 188516]
[9]
Chadha, J.S.; Ashby, D.W.; Cowan, W.K. Fatal intestinal atony in myxoedema. BMJ, 1969, 3(5667), 398.
[http://dx.doi.org/10.1136/bmj.3.5667.398] [PMID: 5797784]
[10]
Nathan, A.W.; Havard, C.W. Paralytic ileus and urinary retention due to hypothyroidism. Br. Med. J. (Clin. Res. Ed.), 1982, 285(6340), 477.
[http://dx.doi.org/10.1136/bmj.285.6340.477] [PMID: 6809133]
[11]
Yaylali, O.; Kirac, S.; Yilmaz, M.; Akin, F.; Yuksel, D.; Demirkan, N.; Akdag, B. Does hypothyroidism affect gastrointestinal motility? Gastroenterol. Res. Pract., 2009.2009529802
[http://dx.doi.org/10.1155/2009/529802] [PMID: 20224642]
[12]
Mathioudakis, N.; Pendleton, C.; Quinones-Hinojosa, A.; Wand, G.S.; Salvatori, R. ACTH-secreting pituitary adenomas: size does not correlate with hormonal activity. Pituitary, 2012, 15(4), 526-532.
[http://dx.doi.org/10.1007/s11102-011-0362-8] [PMID: 22057967]
[13]
Verstraelen, T.E.; Ter Bekke, R.M.; Volders, P.G.; Masclee, A.A.; Kruimel, J.W. The role of the SCN5A-encoded channelopathy in irritable bowel syndrome and other gastrointestinal disorders. Neurogastroenterol. Motil., 2015, 27(7), 906-913.
[http://dx.doi.org/10.1111/nmo.12569] [PMID: 25898860]
[14]
Strege, P.R.; Ou, Y.; Sha, L.; Rich, A.; Gibbons, S.J.; Szurszewski, J.H.; Sarr, M.G.; Farrugia, G. Sodium current in human intestinal interstitial cells of Cajal. Am. J. Physiol. Gastrointest. Liver Physiol., 2003, 285(6), G1111-G1121.
[http://dx.doi.org/10.1152/ajpgi.00152.2003] [PMID: 12893628]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy