Stubborn hiccups as a sign of massive apoplexy in a naive acromegaly patient with pituitary macroadenoma


Bagir G. S. , Civi S., Kardes O., KAYASELÇUK F., Ertorer M. E.

ENDOCRINOLOGY DIABETES AND METABOLISM CASE REPORTS, 2017 (Journal Indexed in ESCI) identifier identifier

  • Publication Type: Article / Article
  • Volume:
  • Publication Date: 2017
  • Doi Number: 10.1530/edm-17-0044
  • Title of Journal : ENDOCRINOLOGY DIABETES AND METABOLISM CASE REPORTS

Abstract

Pituitary apoplexy (PA) may very rarely present with hiccups. A 32-year-old man with classical acromegaloid features was admitted with headache, nausea, vomiting and stubborn hiccups. Pituitary magnetic resonance imaging (MRI) demonstrated apoplexy of a macroadenoma with suprasellar extension abutting the optic chiasm. Plasma growth hormone (GH) levels exhibited suppression (below < 1 ng/mL) at all time points during GH suppression test with 75 g oral glucose. After treatment with corticosteroid agents, he underwent transsphenoidal pituitary surgery and hiccups disappeared postoperatively. The GH secretion potential of the tumor was clearly demonstrated immunohistochemically. We conclude that stubborn hiccups in a patient with a pituitary macroadenoma may be a sign of massive apoplexy that may result in hormonal remission.