THE PITUITARY APOPLEXY INA HAEMODYALISIS PATIENT

Yıl 2010, Cilt: 4 Sayı: 2, 77 - 80, 25.07.2010

Timur Yıldırım

Öz

The pituitary apoplexy is a clinical syndrome characterized with specific clinical findings due to hemorrhage or infarction of a pre-existing pituitary tumor. It is difficult to diagnose the patient in the absence of a pre-established history of pituitary disease.
The association of apoplexy and chronic renal failure is extremely rare in the literature. In this report, we presented a heamodialysis patient who suffered from chronic renal failure for 8 years, applied to our emergency department with acute headache, nausea, vomiting and depression in consciousness and diagnosed as pituitary apoplexy. The patient was treated with conservatively and died in 72 hours after her admission. The most important factor whether the treatment will be surgical or conservative is decided due to patient’s visual acuity alterations.
Chronic renal failure is a multisytem disease, and its detrimental effects are observed in central and peripheral nervous system. We thought that this unique association of the pituitary apoplexy and chronic renal failure causes dismal prognosis.

Anahtar Kelimeler

pituitary apoplexy, chronic renal failure, renal dialysis

HEMODİYALİZ HASTASINDA GELİŞEN PİTUİTER APOPLEKSİ

Öz

Pituiter apopleksi mevcut pituiter tümörün kanama veya enfarktüsüne bağlı spesifik klinik bulgularla karakterize bir klinik sendromdur. Bilinen pituiter hastalık hikayesi yokluğunda teşhisi zordur. Apopleksi ve kronik böbrek yetmezliği birlikteliği literatürde oldukça azdır.
Sunduğumuz olgu, 8 yıldır kronik böbrek yetmezliği sonucu diyaliz tedavisi görmekte olan hasta acil servise başağrısı, bulantı, kusma bilinçte kötüleşme şikayeti ile başvurarak pituiter apopleksi tanısı almıştır. Hasta konservatif olarak tedavi edilmiş ve 72 saat sonra exitus olmuştur.
Tedavinin cerrahi veya medikal olarak mı yapılacağı konusunda verilen kararda en önemli faktör görme keskinliğinin kaybıdır. Kronik böbrek yetmezliği multisistem bir hastalıktır ve zararlı etkileri santral ve periferik sinir sisteminde görülmektedir. Bize göre pituiter apopleksi ve kronik renal yetmezliğin bu nadir birlikteliği kötü pprognoza neden olmaktadır.

Dr. Giyas AYBERK,
Dr. Timur YILDIRIM,
Dr. Mehmet Faik ÖZVEREN,
Dr. Mehmet Oguz KILINÇASLAN’,

Anahtar Kelimeler

Kronik böbrek yetmezliği, hemodiyaliz, pituiter apopleksi

Kaynakça

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