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Hypopituitarism following poisonous viperbite
Sanjay Kumar Bandyopadhyay1, Ranjana Bandyopadhyay, Anita Dutta
1Department of Medicine, NRS Medical College, Kolkata 700014.
Journal of the Indian Medical Association
|October 4, 2012
Summary
A rare case of pituitary damage occurred three years after a viper bite, leading to hormone deficiencies. Hormone replacement therapy helped the patient recover.
Area of Science:
- Endocrinology
- Neurology
Background:
- Viper bites can cause severe systemic effects.
- Pituitary gland damage is a potential, though rare, complication of envenomation.
Observation:
- A 28-year-old male presented with fever, drowsiness, and unconsciousness three years post-viper bite.
- Physical examination revealed scanty body hair, smooth skin, and oral ulcers.
- Endocrine evaluation showed deficiencies in gonadotrophins, thyrotrophin, and corticotrophin, with impaired growth hormone response.
Findings:
- Magnetic Resonance Imaging (MRI) of the brain demonstrated loss of pituitary mass and a 'positive infundibular sign'.
- The sella turcica was filled with cerebrospinal fluid, indicating pituitary destruction.
Implications:
- This case highlights a delayed-onset pituitary insufficiency following a viper bite.
- Early recognition and hormone replacement therapy are crucial for managing such endocrine complications.
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