Cargando…
Neuropsychiatric Manifestations in a Patient with Panhypopituitarism
We present a case of an incidental diagnosis of panhypopituitarism in a 68-year-old African American man admitted to our psychiatric inpatient unit with symptoms suggestive of schizophrenia. The case was unusual as a first-episode psychosis given the patient's age. In the course of his admissio...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5439068/ https://www.ncbi.nlm.nih.gov/pubmed/28567321 http://dx.doi.org/10.1155/2017/5082687 |
_version_ | 1783237881102336000 |
---|---|
author | Jegede, Oluwole Jeyakumar, Ajouka Balakumar, Thyarapan Raghu, Alyssa Chang, Katherine I. Soewono, Katarina Gustave, Mario Jolayemi, Ayodeji |
author_facet | Jegede, Oluwole Jeyakumar, Ajouka Balakumar, Thyarapan Raghu, Alyssa Chang, Katherine I. Soewono, Katarina Gustave, Mario Jolayemi, Ayodeji |
author_sort | Jegede, Oluwole |
collection | PubMed |
description | We present a case of an incidental diagnosis of panhypopituitarism in a 68-year-old African American man admitted to our psychiatric inpatient unit with symptoms suggestive of schizophrenia. The case was unusual as a first-episode psychosis given the patient's age. In the course of his admission, the patient's clinical condition deteriorated culminating in a sudden altered mental status which prompted a transfer to the medical floors and further investigations. A head CT scan and a pituitary MRI revealed a near total resection of the pituitary while laboratory investigations revealed hyponatremia and a grossly low hormone profile. The progression of these events casts doubts on our admitting diagnosis as the primary cause of the patient's symptoms. The patient's clinical condition improved only when his endocrinopathy was treated with hormone replacement, fluids, and electrolyte correction in addition to antipsychotics. An inability to verify the patient's psychiatric history and a remote history of pituitary resection several decades earlier, unknown to the treating team, added to the diagnostic conundrum. We revised the diagnosis to neuropsychiatric manifestations secondary to an organic brain syndrome due to a partial pituitary resection. The patient was discharged with no symptoms of psychosis, good insight, judgment, and good reality testing. |
format | Online Article Text |
id | pubmed-5439068 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-54390682017-05-31 Neuropsychiatric Manifestations in a Patient with Panhypopituitarism Jegede, Oluwole Jeyakumar, Ajouka Balakumar, Thyarapan Raghu, Alyssa Chang, Katherine I. Soewono, Katarina Gustave, Mario Jolayemi, Ayodeji Case Rep Psychiatry Case Report We present a case of an incidental diagnosis of panhypopituitarism in a 68-year-old African American man admitted to our psychiatric inpatient unit with symptoms suggestive of schizophrenia. The case was unusual as a first-episode psychosis given the patient's age. In the course of his admission, the patient's clinical condition deteriorated culminating in a sudden altered mental status which prompted a transfer to the medical floors and further investigations. A head CT scan and a pituitary MRI revealed a near total resection of the pituitary while laboratory investigations revealed hyponatremia and a grossly low hormone profile. The progression of these events casts doubts on our admitting diagnosis as the primary cause of the patient's symptoms. The patient's clinical condition improved only when his endocrinopathy was treated with hormone replacement, fluids, and electrolyte correction in addition to antipsychotics. An inability to verify the patient's psychiatric history and a remote history of pituitary resection several decades earlier, unknown to the treating team, added to the diagnostic conundrum. We revised the diagnosis to neuropsychiatric manifestations secondary to an organic brain syndrome due to a partial pituitary resection. The patient was discharged with no symptoms of psychosis, good insight, judgment, and good reality testing. Hindawi 2017 2017-05-08 /pmc/articles/PMC5439068/ /pubmed/28567321 http://dx.doi.org/10.1155/2017/5082687 Text en Copyright © 2017 Oluwole Jegede et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Jegede, Oluwole Jeyakumar, Ajouka Balakumar, Thyarapan Raghu, Alyssa Chang, Katherine I. Soewono, Katarina Gustave, Mario Jolayemi, Ayodeji Neuropsychiatric Manifestations in a Patient with Panhypopituitarism |
title | Neuropsychiatric Manifestations in a Patient with Panhypopituitarism |
title_full | Neuropsychiatric Manifestations in a Patient with Panhypopituitarism |
title_fullStr | Neuropsychiatric Manifestations in a Patient with Panhypopituitarism |
title_full_unstemmed | Neuropsychiatric Manifestations in a Patient with Panhypopituitarism |
title_short | Neuropsychiatric Manifestations in a Patient with Panhypopituitarism |
title_sort | neuropsychiatric manifestations in a patient with panhypopituitarism |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5439068/ https://www.ncbi.nlm.nih.gov/pubmed/28567321 http://dx.doi.org/10.1155/2017/5082687 |
work_keys_str_mv | AT jegedeoluwole neuropsychiatricmanifestationsinapatientwithpanhypopituitarism AT jeyakumarajouka neuropsychiatricmanifestationsinapatientwithpanhypopituitarism AT balakumarthyarapan neuropsychiatricmanifestationsinapatientwithpanhypopituitarism AT raghualyssa neuropsychiatricmanifestationsinapatientwithpanhypopituitarism AT changkatherinei neuropsychiatricmanifestationsinapatientwithpanhypopituitarism AT soewonokatarina neuropsychiatricmanifestationsinapatientwithpanhypopituitarism AT gustavemario neuropsychiatricmanifestationsinapatientwithpanhypopituitarism AT jolayemiayodeji neuropsychiatricmanifestationsinapatientwithpanhypopituitarism |