Neuropsychiatric Manifestations in a Patient with PanhypopituitarismReport as inadecuate




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Case Reports in Psychiatry - Volume 2017 2017, Article ID 5082687, 3 pages - https:-doi.org-10.1155-2017-5082687

Case Report

Interfaith Medical Center, Brooklyn, NY, USA

American University of Antigua, Osbourn, Saint Kitts and Nevis

Medical University of the Americas, Charlestown, Saint Kitts and Nevis

Correspondence should be addressed to Oluwole Jegede

Received 20 January 2017; Revised 28 March 2017; Accepted 12 April 2017; Published 8 May 2017

Academic Editor: Jaspreet S. Brar

Copyright © 2017 Oluwole Jegede et al.
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We present a case of an incidental diagnosis of panhypopituitarism in a 68-year-old African American man admitted to our psychiatric inpatient unit with symptoms suggestive of schizophrenia.
The case was unusual as a first-episode psychosis given the patient’s age.
In the course of his admission, the patient’s clinical condition deteriorated culminating in a sudden altered mental status which prompted a transfer to the medical floors and further investigations.
A head CT scan and a pituitary MRI revealed a near total resection of the pituitary while laboratory investigations revealed hyponatremia and a grossly low hormone profile.
The progression of these events casts doubts on our admitting diagnosis as the primary cause of the patient’s symptoms.
The patient’s clinical condition improved only when his endocrinopathy was treated with hormone replacement, fluids, and electrolyte correction in addition to antipsychotics.
An inability to verify the patient’s psychiatric history and a remote history of pituitary resection several decades earlier, unknown to the treating team, added to the diagnostic conundrum.
We revised the diagnosis to neuropsychiatric manifestations secondary to an organic brain syndrome due to a partial pituitary resection.
The patient was discharged with no symptoms of psychosis, good insight, judgment, and good reality testing.





Author: Oluwole Jegede, Ajouka Jeyakumar, Thyarapan Balakumar, Alyssa Raghu, Katherine I.
Chang, Katarina Soewono, Mario Gustave, a


Source: https://www.hindawi.com/



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