Abstract
ABSTRACT Objective: Chronic cocaine use has been implicated in panhypopituitarism. Acute cocaine intoxication resulting in pituitary apoplexy and panhypopituitarism has not been reported in the literature. Methods: We hereby report a case of panhypopituitarism resulting from pituitary apoplexy induced by a single intranasal cocaine use. Results: A 54-year-old African American man presented with a week-long headache that started 2 hours after snorting a gram of cocaine. His physical exam was normal. His labs were suggestive of panhypopituitarism. Anti-neutrophil cytoplasmic antibodies were negative. Brain magnetic resonance imaging with and without contrast showed a large complex sellar mass with hemorrhagic and necrotic components. Surgical decompression was deferred due to normal visual acuity and absence of visual field defects. He received a stress dose of glucocorticoids followed by maintenance dose and was discharged on the glucocorticoid with levothyroxine replacement. The patient has been lost to f...
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