Pituitary apoplexy medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]

Overview

The optimal therapy for pituitary apoplexy depends upon the presentationn of the patient. The emphasis is on early hemodynamic stabilization of the patient, with evaluation for signs of pituitary hormones deficiency. Life threatening hypopituitarism must be treated with replacement of hormones.

Medical Therapy

Medical treatment consists of:^[1]^[2]^[3]

Hemodynamic stabilization of the patient with evaluation for signs of pituitary hormones deficiency and electrolyte abnormalities.
Most patients have life threatening hypopituitarism. Replace hormones with:
- High-dose corticosteroids
- Sex hormones (estrogen/testosterone)
- Thyroid hormone
Evidence is also growing for the need to replace growth hormone.

References

↑ Veldhuis JD, Hammond JM (1980). “Endocrine function after spontaneous infarction of the human pituitary: report, review, and reappraisal”. Endocr. Rev. 1 (1): 100–7. doi:10.1210/edrv-1-1-100. PMID 6785084.
↑ Oelkers W (1996). “Adrenal insufficiency”. N. Engl. J. Med. 335 (16): 1206–12. doi:10.1056/NEJM199610173351607. PMID 8815944.
↑ De Ycaza AE, Chang AY, Jensen JR, Khan Z, Erickson D (2015). “Approach to the management of rare clinical presentations of macroprolactinomas in reproductive-aged women”. Case Rep Womens Health. 8: 9–12. doi:10.1016/j.crwh.2015.09.001. PMC 5033506. PMID 27668187.

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[pmid6785084-1] Veldhuis JD, Hammond JM (1980). “Endocrine function after spontaneous infarction of the human pituitary: report, review, and reappraisal”. Endocr. Rev. 1 (1): 100–7. doi:10.1210/edrv-1-1-100. PMID 6785084.

[pmid8815944-2] Oelkers W (1996). “Adrenal insufficiency”. N. Engl. J. Med. 335 (16): 1206–12. doi:10.1056/NEJM199610173351607. PMID 8815944.

[pmid27668187-3] De Ycaza AE, Chang AY, Jensen JR, Khan Z, Erickson D (2015). “Approach to the management of rare clinical presentations of macroprolactinomas in reproductive-aged women”. Case Rep Womens Health. 8: 9–12. doi:10.1016/j.crwh.2015.09.001. PMC 5033506. PMID 27668187.

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