Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 32-year-old woman, a 73-year-old man and a 26-year-old pregnant woman presented with headache, vomiting, and variable presence of visual disturbances, impaired consciousness, and circulatory shock. All three had pituitary apoplexy. In the first patient lymphocytic hypophysitis was diagnosed, the second had a nonfunctional adenoma and the last patient probably also. All three patients were treated conservatively with full recovery of signs and symptoms. However pituitary insufficiency remained in all three. Pituitary apoplexy is an acute event with significant morbidity and mortality. The cause is a rapid expansion of, usually, a pre-existing, often not yet known, adenoma by massive haemorrhage or infarction. Pressure, among other things, causes hypopituitarism, meningism, compression of the chiasma opticum and visual disturbances. Although many predisposing factors have been identified, pituitary apoplexy is often an unpredictable event. Diagnosis is made by the typical clinical presentation, eye examination, MRI and by measuring pituitary hormones. Treatment is with suppletion of the deficient hormones and in selected patients by transsphenoidal decompression surgery.
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PMID:[Pituitary apoplexy: an endocrinologic emergency]. 1637 21

A case of 68-aged male with hypopituitarism who suffered from faints and syncope with nauseas, vomiting and a significant body mass decrease, progressing during 3 yr. was presented. Diagnosis of hypopituitarism was established 3 yr. after symptoms onset. Diagnostic problems concerning hypopituitarism were described, indicating consideration of this uncommon disease in differential diagnosis of disorders which major symptoms are faints and syncope.
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PMID:[Hypopituitarism: interdisciplinary diagnostic issue]. 1863 28

Atypical teratomas of the pineal were studied pathologically and clinically, and five illustrative cases are described. The results of three postmortem examinations are available, while two of the patients are living, one leading a normal life. Pathological verification revealed that two had suprasellar "ectopic" pinealomas. One neoplasm was located in the pineal (collicular) region. The histology of the tumours was identical, consisting of small cells resembling lymphocytes and large cells with prominent nucleoli and mitoses. This feature plus the midline location led to adoption of the term "atypical teratoma". Patients with collicular pinealomas presented with headache, vomiting, papilledema, Parinaud's syndrome and, rarely, nystagmus retractorius. Diabetes insipidus, visual difficulty and hypopituitarism were characteristic features in those with suprasellar neoplasms. Treatment of collicular pinealoma has consisted of the use of a palliative shunt followed by a course of radiation. Chiasmal decompression and radiation have produced favourable results in patients with suprasellar pinealoma.
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PMID:Atypical Teratomas of the Pineal. 2032 17

Severe hyponatremia occurring as the presenting feature of hypopituitarism secondary to pituitary adenomas is rare. We report three patients with this condition: Two elderly males (74 and 78 year-old) presenting with impaired consciousness and low plasma sodium after an episode of diarrhea and a 56-year-old male presenting with impaired consciousness after an episode of vomiting. All had clinical features of hypopituitarism and pituitary adenomas were found on imaging studies. Two were subjected to a trans sphenoidal resection of the adenoma.
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PMID:[Hyponatremia associated to pituitary adenomas. Report of three patients]. 2036 Nov 38

Sarcoidosis is a multi-system granulomatous disease of unknown etiology. It mainly affects the lungs more than other organs, but liver, skin, lymph nodes, and nervous system can be involved. The last is referred to as neurosarcoidosis with a wide range of clinical manifestations depending on the area of the nervous system involved. The differential diagnosis is wide, and the diagnosis, which is based on the histopathology, is sometimes difficult to confirm. Magnetic resonance imaging is the imaging modality of choice for establishing CNS involvement along with the clinical presentation. Cerebrospinal fluid analysis is indicative of the disease activity. We report a 39-year-old man of Indian origin who presented with persistent vomiting for over 2 years due to hypopituitarism and active neurosarcoidosis.
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PMID:Neurosarcoidosis presenting with persistent vomiting. 2067 1

A 57-year-old man was admitted with headache, vomiting, and bloody sputum. We diagnosed large cell lung cancer T4N2M1 (pituitary metastasis), Stage IV. When hospitalized, low values of cortisol and hyponatremia were found. A hormone stimulation test was performed, because we suspected hypopituitarism. The reaction of adrenocorticotropic hormone (ACTH) to the corticotropin-releasing hormone (CRH) loading test was good, but the reaction of serum cortisol was minimal. After corticosteroid administration, his serum sodium normalized. Limited ACTH reserve according to insufficient pituitary function was suggested as a cause of the hyponatremia. He received gamma-knife therapy, however his pituitary gland tumor did not decrease in size. Clinical symptoms such as visual field disturbance, oculomotor paresis, and visual impairment progressed, and he died about 5 months later. We report a case of hyponatremia in a patient with pituitary metastasis of lung cancer, as it is comparatively rare.
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PMID:[Hyponatremia caused by pituitary metastasis of lung cancer]. 2168 46

We describe a rare case of transient thyrotoxicosis secondary to painless thyroiditis accompanied by panhypopituitarism caused by ruptured Rathke's cleft cyst. A 32-year-old man presented with vomiting and diarrhea. Laboratory data showed that he had transient hypercalcemia, primary thyrotoxicosis due to painless thyroiditis and panhypopituitarism. The sellar magnetic resonance imaging showed cystic macroadenoma. He underwent surgical exploration. Histological examination showed a ruptured Rathke's cleft cyst. Our case suggests that, although rare, it is important to recognize the possibility of coexistence of hypopituitarism in patients with primary thyrotoxicosis.
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PMID:Transient thyrotoxicosis accompanied by panhypopituitarism caused by ruptured Rathke's cleft cyst. 2218 92

A 58-year-old white woman presented with sudden onset of diplopia, headache and vomiting with a history of tiredness and lethargy over the past four to six months. She had smooth, pale, hairless skin and on examination she was found to have left-sided third and sixth nerve palsy. Laboratory tests confirmed pan-anterior hypopituitarism. Computerized tomography scan of head and magnetic resonance imaging appearances were consistent with those of a sphenoid sinus mucocoele. Following adequate replacement with hydrocortisone and thyroxine she underwent sphenoid mucocoele drainage and endoscopic left sphenoethmoidectomy. Her symptoms were relieved over the next few days and she had a near-total recovery of ophthalmoplegia over the following three months. Pituitary function tests showed partial resolution of hypopituitarism with recovery of hypothalamic-pituitary-adrenal axis and hydrocortisone therapy was withdrawn, but she continued to require thyroxine.
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PMID:Sphenoid mucocele: an uncommon complication of a rare condition. 2291 86

Pituitary apoplexy is a rare condition which may cause death of the patient in severe cases and many times leads to hypopituitarism. We report a case of apoplexy in a large prolactinoma resulting in empty sella syndrome followed by a successful pregnancy. Our patient is a 32-year-old female with a history of a macroprolactinoma for approximately 17 years who presented to our hospital with a history of severe headache, decreased level of consciousness, fever, nausea, vomiting, and diplopia of 12 hours duration. Magnetic resonance imaging done on admission showed an increase in the size of the pituitary adenoma with a subtle hemorrhage. The patient was admitted to the intensive care unit and treated conservatively. The condition of the patient improved within a few days. A few months later, she started having regular menstrual periods. A magnetic resonance imaging of the pituitary 1.5 years later was reported as empty sella syndrome, and approximately one year later she became pregnant. With the pituitary adenoma being resolved after developing pituitary apoplexy and continuing on cabergoline, the patient had a successful pregnancy with no recurrence of the adenoma after delivery and breastfeeding.
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PMID:Successful pregnancy in a female with a large prolactinoma after pituitary tumor apoplexy. 2419 92

Pituitary apoplexy is a rare but potentially life-threatening clinical syndrome characterized by ischemic infarction or hemorrhage into a pituitary tumor. The diagnosis of pituitary tumor apoplexy is frequently complicated because of the nonspecific nature of its signs and symptoms, which can mimic different neurological processes, including meningitis. Several factors have been associated with apoplexy, such as dopamine agonists, radiotherapy, or head trauma, but meningitis is a rarely reported cause. We describe the case of a 51-year-old woman with acromegaly due to a pituitary macroadenoma. Before surgical treatment, she arrived at Emergency with fever, nausea, vomiting and meningismus. Symptoms and laboratory tests suggested bacterial meningitis, and antibiotic therapy was initiated, with quick improvement. A computerized tomography (CT) scan at admission did not reveal any change in pituitary adenoma, but a few weeks later, magnetic resonance imaging (MRI) showed data of pituitary apoplexy with complete disappearance of the adenoma. Currently, her acromegaly is cured, but she developed hypopituitarism and diabetes insipidus following apoplexy. We question whether she really experienced meningitis leading to apoplexy or whether apoplexy was misinterpreted as meningitis. In conclusion, the relationship between meningitis and pituitary apoplexy may be bidirectional. Apoplexy can mimic viral or bacterial meningitis, but meningitis might cause apoplexy, as well. This fact highlights the importance of differential diagnosis when evaluating patients with pituitary adenomas and acute neurological symptoms.
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PMID:Spontaneous remission of acromegaly: apoplexy mimicking meningitis or meningitis as a cause of apoplexy? 2472 69


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