Analysis of 13 Misdiagnosed Cases of Geratic Pituitary Crisis
LI Bao-jun
Abstract：Objective To explore the characteristics of pituitary crisis, and to put forward approaches to prevent mis-diagnosis. Methods The clinical data of 13 misdiagnosed geriatric pituitary crisis cases admitted to the emergency depart-ment of our hospital during the period from June 2010 to June 2014 were retrospectively analysed. Results In the 13 cases, 4 were misdiagnosed as hypovolemic shock, 5 cases were misdiagnosed as hypoglycemic coma, 2 cases as Alzheimer's disease, 1 case as electrolyte disorder and 1 case as brain stem stroke. All the cases were diagnosed as pituitary crisis combined with the patients' medical histories, clinical manifestations and target gland hormone levels. After glucocorticoids and symptomatic treatments, 9 patients' condition improved rapidly, and the pituitary crisis was relieved, except for 2 deaths due to major bleeding when the pituitary was ruptured. When the condition returned stable, they were given prednisone and levothyroxine as an alternative treatment till they were discharged from hospital. Conclusion In cases of sudden coma of unknown cause in geriatric patients, we should think about the possibility of pituitary crisis, especially those with hypoglycemia and hyponatrem-ia. For suspects, we should give emergency treatments as soon as blood sampling is taken, instead of waiting for the inspection results. Glucocorticoids should be given as an experimental treatment if necessary.
Keywords：Pituitary crisisAgedDiagnostic error
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：3( 21-22,23 )