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Pituitary apoplexy with spontaneous cure of acromegaly and its possible relation to Gd-DTPA-administration

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Summary

A case of pituitary apoplexy occurring after Gd-DTPA-administration for contrast enhanced MRI in a patient with an hGH-producing macro-adenoma is presented. Within days the initially increased hGH level fell to the normal range, the oral glucose tolerance test (OGTT) showed a normal suppression of hGH and complete anterior pituitary insufficiency developed. At this time repeated MRI suggested a haemorrhagic infarction of the macroadenoma. Fourteen months later re-examination confirmed spontaneous cure of the acromegaly, improvement of adenopituitary function and shrinkage of the sellar content. The causal linkage between the pituitary adenoma apoplexy and Gd-DTPA-administration is unclear. It might be due to contrast induced blood pressure and endothelial permeability changes, possibly promoted by pre-existing diabetes mellitus associated vasculopathy.

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Authors and Affiliations

  1. Department of Clinical Biochemistry, University of Bonn, Bonn, Germany

    M. Wichers, W. Springer & D. Klingmüller

  2. Department of Neurosurgery, University of Bonn, Bonn, Germany

    R. A. Kristof & J. Schramm

Authors
  1. M. Wichers
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  2. R. A. Kristof
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  3. W. Springer
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  4. J. Schramm
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  5. D. Klingmüller
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Additional information

This manuscript is dedicated to Prof. Dr. Dr. F. Bidlingmaier on occasion of his 60th birthday

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Wichers, M., Kristof, R.A., Springer, W. et al. Pituitary apoplexy with spontaneous cure of acromegaly and its possible relation to Gd-DTPA-administration. Acta neurochir 139, 992–994 (1997). https://doi.org/10.1007/BF01411312

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  • DOI: https://doi.org/10.1007/BF01411312

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