Table 1 Clinical characteristics of patients diagnosed with pituitary apoplexy induced by gonadotropin-releasing hormone agonists
Authors | Patient age (years) | Drug | Time of onset | Pathologic finding | Symptoms and signs | Treatment |
|---|---|---|---|---|---|---|
2013 | 77 | 1st Leuprorelin | Hours | Degenerative cells | Severe H/A, N/V, ptosis | Tumor removal (surgery) |
Current | Taiwan | 3.75 mg | Necrotic debris | Partial ophthalmoplegia | ||
2010 | 60 | 1st Leuprolide | Hours | Necrotic tissue | Mild H/A, blurry vision | Tumor removal (surgery) |
Guerra | Hemorrhage; | 48 h: ptosis/EOM limitation | ||||
Stain: LH(+) | 9 days: persistent H/A, ptosis, complete ophthalmoplegia | |||||
2007 | 60 | 1st Leuprolide | 4 h | Pituitary adenoma | H/A, N/V, â–³MS, and VD, ptosis, mild palsy of CN III. | Medical stabilization |
Hands | 22.5 mg | Stain: LH(+), FSH(-), | 2 weeks: H/A↑,diplopia, weakness | Tumor removal (surgery) | ||
PRL(-) | 3 weeks (untreated): confused, Left CN III, IV, VI paralysis, | |||||
2006 | 70 | 1st Leuprolide | 10 days | Pituitary adenoma | VD, diplopia and intracranial HTN, ptosis | SMA (little effect) |
Massoud, | 11.25 mg | 3 months: tumor removal (surgery) | ||||
2006 | 61 | 1st Leuprolide | Few hours | Pituitary adenoma | Severe H/A, N/V, ptosis, diplopia | Tumor removal (surgery) |
Davis | 30 mg | 2 days: ptosis, diplopia, CN III palsy, VD | ||||
2006 | 68 | 1st Goserelin, | 4-6 h | Pituitary adenoma | Mild H/A, | Tumor removal (surgery) |
Blaut | 3,6 mg | 5-7 days: severe H/A, N/V, â–³consciousness, diplopia, ptosis, | ||||
2003 | 69 | 1st Leuprolide | Hours | Pituitary adenoma | H/A, VD, few days later: DI | Tumor removal (surgery) |
Hernandez | Stain: FSH(+) | |||||
2001 | 67 | 1st Goserelin | 4 h | Pituitary adenoma | H/A, N/V | IV hydrocortisone |
Eaton | 3.6 mg | Hemorrhage, Necrosis | 13 h: Visual loss and severe H/A, mildly confused, HTN, | 36 h: Discontinue of Goserelin | ||
Stain: LH(+), FSH(+) | 6 days: cortisone replacement | |||||
1997 | 62 | 1st Leuprorelin | Soon after injection | Stain: LH(+), FSH(+) | Sudden intracranial HTN | Surgery |
Reznik | ||||||
1996 | 74 | 1st Leuprolide | 15 min | Pituitary adenoma | Severe H/A, generalized weakness, N/V. | Steroid therapy |
Morsi | 7.5 mg | Stain: FSH(+), LH(+) | 2 days: consciousness disturbance, ophthalmoplegia | 3rd day: decompression of the mass | ||
1995 | 78 | Triptorelin | Few mins | No biopsy | H/A | Discontinue of the GnRH agonist |
Chanson | 3.75 mg | (CT: suprasellar mass) | 24 h: dizziness, partial ophthalmoplegia | Conservative management | ||
1995 | 83 | Goserelin | 9 days | No biopsy | H/A, N/V | Replacement therapy: 30 mg prednisolone QD |
Ando | 3.6 mg | (CT: suprasellar mass) | 9-13 days: â–³ consciousness, hyponatremia, diplopia, |