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- Yumiko Yoshino, Yoshihiro Harano, Toshiro Shibata, and Junko Shiroko.
- Department of Internal Medicine, Takayama Red Cross Hospital, Japan.
- Intern. Med. 2024 Dec 15; 63 (24): 333333383333-3338.
AbstractHypopituitarism is difficult to diagnose because of its non-specific symptoms, especially in the presence of comorbidities. A 77-year-old woman with worsening anorexia and exertional dyspnea was initially diagnosed with decompensated dry cold-type heart failure. Hormonal laboratory tests indicated secondary hypothyroidism as a part of the evaluation of heart failure. Furthermore, pituitary magnetic resonance imaging revealed thickening of the pituitary stalk and a loss of signal intensity in the posterior pituitary, thus suggesting lymphocytic hypophysitis. Oral hydrocortisone and levothyroxine improved the persistent anorexia. In this case, hypopituitarism occasionally presented as dry cold-type heart failure, thus making a prompt diagnosis challenging in the setting of concurrent heart failure.
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