Snake bite induced delayed hypopituitarism: a rare case report

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dc.contributor.authorBhowmick, Niladrien_US
dc.contributor.authorMukhopadhyay, Jotideben_US
dc.contributor.authorKar, Soumyadipen_US
dc.contributor.authorDas, Amritaen_US
dc.date.accessioned2020-11-18T10:02:33Z
dc.date.available2020-11-18T10:02:33Z
dc.date.issued2020-09
dc.description.abstractHypopituitarism following snake bite induced AKI and dialysis is an uncommon complication. Often the presentation is delayed and Can present with a myriad of features. We present a case of a 27 year old male patient, with past history of snake bite and acute kidney injury (AKI) requiring dialysis and which subsequently resolved, presenting to us with fatigability and weakness, absence of secondary sexual character and poor academic performance. On examination, the patient had pale white and coarse skin. Hoarseness of voice was present. There was proximal upper and lower limb muscle weakness present with pseudo myotonia on examination. There was loss of axillary and pubic hair with low testicular volume. Routine reports suggested mildly elevated creatinine with severely elevated Triglyceride levels. Creatine phosphokinase (CPK) was raised. Hormonal profile revealed low free thyroxine (FT4) and serum 8 a.m. Cortisol but an inadequate increase in thyroid stimulating hormone (TSH) and adrenocorticotropic hormone (ACTH) levels were suggestive of central hypopituitarism. Luteinizing hormone (LH), follicle-stimulating hormone (FSH), Insulin-like growth factor 1 (IGF-1) levels were reduced. Neuroimaging revealed empty sella suggestive of pituitary apoplexy. The above were suggestive of delayed hypopituitarism following post snake bite dialysis mediated pituitary apoplexy. In all cases of snake bite, a common occurrence in our country the possibility of hypopituitarism should be kept in mind and the hormonal profile followed up closely along with the renal parameters.en_US
dc.identifier.affiliationsDepartment of General Medicine, Institute of Post-graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, Indiaen_US
dc.identifier.citationBhowmick Niladri, Mukhopadhyay Jotideb, Kar Soumyadip, Das Amrita. Snake bite induced delayed hypopituitarism: a rare case report. International Journal of Research in Medical Sciences. 2020 Sep; 8(9): 3383-3385en_US
dc.identifier.issn2320-6071
dc.identifier.issn2320-6012
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/212606
dc.languageenen_US
dc.publisherMedip Academyen_US
dc.relation.issuenumber9en_US
dc.relation.volume8en_US
dc.source.urihttps://dx.doi.org/10.18203/2320-6012.ijrms20203699en_US
dc.subjectAcute kidney injuryen_US
dc.subjectEmpty sellaen_US
dc.subjectHypothyroidismen_US
dc.subjectHypopituitarismen_US
dc.subjectSnake biteen_US
dc.subjectRussel’s viperen_US
dc.titleSnake bite induced delayed hypopituitarism: a rare case reporten_US
dc.typeJournal Articleen_US
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