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Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Lymphocytic hypophysitis is an inflammatory /autoimmune disorder that primarily involves the pituitary gland and the pituitary stalk. The common clinical presentations include headache, nausea, vomiting, fatigue, features of hypopituitarism and diabetes insipidus as well as diplopia, orbital pain and bitemporal hemianopia. We report a case of lymphocytic hypophysitis which presented as hemichorea. Neuroimaging showed a mass in the sella tursica region which, on histopathological examination was suggestive of lymphocytic hypophysitis. After excision of this mass, patient showed marked improvement in his symptoms albeit he developed panhypopituitarism. The patient was treated with pituitary hormonal replacement therapy and is currently asymptomatic.
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PMID:Lymphocytic Hypophysitis Mimicking Pituitary Macroadenoma. 2852 71

Pituitary apoplexy (PA) is a clinical syndrome caused by acute haemorrhage and/or infarction of the pituitary gland, generally within a frequently undiagnosed pituitary adenoma. The sudden increase in pituitary gland volume is responsible for typical symptoms: severe headache, nausea, vomiting, visual impairment, cranial nerve palsies, deteriorating level of consciousness, and hypopituitarism. Radiological evidence, especially magnetic resonance imaging (MRI) which is the most sensitive diagnostic modality, establishes the diagnosis. Multiple risk factors have been reported, although the majority of cases have no identifiable precipitants. The management strategy depends on the clinical manifestation, as well as the presence of co-morbidities, and remains controversial. Post apoplexy, there needs to be careful monitoring for recurrence of tumour growth and endocrinological function of the pituitary. This disease is rare but potentially life-threatening without rapid treatment. Because there are no randomised studies, it is suggested that further trials are needed to optimise proper management.
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PMID:Pituitary apoplexy. 3174 69

A 49-year-old female with history of daily inhaled corticosteroid use for asthma presented to a concussion clinic 7 wk after sport-related head injury with headache, visual blurring, dizziness, nausea, fatigue, polydipsia, and polyuria. Examination revealed difficulty with vestibuloocculomotor testing due to nausea and visual straining. Cranial computed tomography/magnetic resonance imaging was unremarkable. Laboratory testing revealed critically low serum cortisol, hypernatremia, and urine studies suggesting diabetes insipidus. The patient was referred to the emergency department. Intravenous fluid resuscitation, corticosteroids, and desmopressin led to significant symptomatic relief. She was maintained on oral hydrocortisone after cosyntropin test revealed adrenal insufficiency. Her clinical picture suggested chronic subclinical adrenal suppression from inhaled corticosteroids which was exacerbated by hypopituitarism from concussion combined with diabetes insipidus. Adrenal insufficiency should be considered in athletes with history of corticosteroid use and endocrine-related symptoms after concussion, because this can create significant morbidity and can mimic traditional symptoms of concussion.
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PMID:Sport-Related Concussion Preceding Adrenal Insufficiency and Hypopituitarism. 3191 17


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