Pericardial Effusion as an Initial Presentation of Panhypopituitarism

Abstract

Pericardial effusion has a broad spectrum of clinical presentation, ranging from an incidental finding on imaging to a potentially fatal emergency such as pericardial tamponade, the most severe presentation. The authors present a case of a middle-aged male hospitalized due to shortness of breath. Initial work-up was positive for massive pericardial effusion with haemodynamic compromise. Additional study revealed panhypopituitarism. The acromegalic phenotype was suggestive of acromegaly secondary to pituitary adenoma, which had probably evolved to apoplexy. Hormone replacement was started with clinical improvement. At the 3-year follow-up, there was no evidence of recurrence of pericardial effusion. Panhypopituitarism is a relatively rare entity, but can lead to life-threatening complications such as adrenal crisis, coma and myxoedema-associated cardiac failure. Pericardial effusion is an extremely rare manifestation of secondary hypothyroidism.

Recurrent Pericardial Effusion Due to Panhypopituitarism: A Rare Case Report

“…They can be grouped into inflammatory (due to viruses, bacteria, and mycobacterial infections, cardiac injury, autoimmune syndrome, urea, and drug hypersensitivity) and non-inflammatory (primary or secondary, metabolic, traumatic, or due to reduced lymphatic drainage). The preferred examination modality for diagnosis is echocardiography, which allows pericardial effusion to be classified according to size, localization, and hemodynamic status ( 1 ).…”