Hypopituitarism Presenting as Adrenal Insufficiency and Hypothyroidism in a Patient with Wilson's Disease: a Case Report.
Wilson's disease typically presents symptoms associated with liver damage or neuropsychiatric disturbances, while endocrinologic abnormalities are rare. We report an unprecedented case of hypopituitarism in a patient with Wilson's disease. A 40-year-old woman presented with depression, general weakness and anorexia. Laboratory tests and imaging studies were compatible with liver cirrhosis due to Wilson's disease. Basal hormone levels and pituitary function tests indicated secondary hypothyroidism and adrenal insufficiency due to hypopituitarism. Brain MRI showed T2 hyperintense signals in both basal ganglia and midbrain but the pituitary imaging was normal. She is currently receiving chelation therapy along with thyroid hormone and steroid replacement. There may be a relationship between Wilson's disease and hypopituitarism. Copper deposition or secondary neuronal damage in the pituitary may be a possible explanation for this theory.
['Lee|Hae Won|HW|0000-0002-7744-2187', 'Kang|Jin Du|JD|0000-0003-2191-7718', 'Yeo|Chang Woo|CW|0000-0001-5753-4191', 'Yoon|Sung Woon|SW|0000-0001-7073-020X', 'Lee|Kwang Jae|KJ|0000-0001-5468-6499', 'Choi|Mun Ki|MK|0000-0002-5725-7128']
D000309:Adrenal Insufficiency D000328:Adult D001921:Brain D003863:Depression D005260:Female D006527:Hepatolenticular Degeneration D006801:Humans D007018:Hypopituitarism D007037:Hypothyroidism D008103:Liver Cirrhosis D008279:Magnetic Resonance Imaging D013256:Steroids D013973:Thyrotropin-Releasing Hormone
Hypopituitarism Adrenal Insufficiency Hypothyroidism Hepatolenticular Degeneration