Une complication rare de macroadénome hypophysaire : méningite bactérienne

Daouda, Moussa Toudou; Obenda, Norlin Samuel; Maazou, L.; Souirti, Zouhayr; Belahsen, M.F.

doi:10.1016/j.neurol.2015.07.003

Cited by 1 publication

(4 citation statements)

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“…Only one case of transient elevation of ACTH with hypercortisolemia associated with hyperprolactinemia was observed in our study[14]. On the other hand, we have underlined 4 cases of panhypopituitarism associated with hyperprolactinemia[1,5,9,10]. The panhypopituitarism would probably be secondary to a compression of the pituitary stem disconnecting the pituitary gland, which is a rare situation in the PM.Dopaminergic agonists (cabergoline or bromocriptine) represent the first choice treatment of macroprolactinomas without alteration of the ophthalmic examination (fundus examination and visual field).…”

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confidence: 46%

“…Clinical signs probably related to the PM were decrease of visual acuity (6.25%) and ophthalmoplegia (12.5%). The visual troubles could be explained by compression of the optochiasmatic tract [9]. Ophthalmoplegia is the consequence of the invasion or compression of the oculomotor nerves in the cavernous sinus by the PM [9].…”

Section: Discussionmentioning

confidence: 99%

“…The visual troubles could be explained by compression of the optochiasmatic tract [9]. Ophthalmoplegia is the consequence of the invasion or compression of the oculomotor nerves in the cavernous sinus by the PM [9]. The disturbance of consciousness could also be a sign related to PM by endocrine disorders especially the lackness of corticotropic axis [1,5,9,10].…”

Section: Discussionmentioning

confidence: 99%

“…In terms of physiopathological, the occurrence of BM could be explained by the fact that PM destroy the sellar floor and invade the sphenoid sinus and the meninges creating an osteomeningeal breach with leakage of the CSF (rhinorrhea) responsible for the bacterial infection of the meninges and cerebral structures [9]. The rhinorrhea can precede the BM [2, 4…”

Section: Discussionmentioning

confidence: 99%

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Bacterial Meningitis Associated With Pituitary Macroadenoma: Systematic Review.

Daouda

Assadeck

Djibo

2017

JNRT

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Introduction -Bacterial meningitis complicates rarely pituitary macroadenomas. The aim of our systematic review is to study the features of the association between bacterial meningitis and pituitary macroadenoma.Methods -We conducted a literature search in both MedLine and Google Scholar database from 1967 to October 2016 and reviewed all cases described of the association between bacterial meningitis and pituitary macroadenoma apart from any surgical act and without pituitary apoplexy.Results -We found 14 articles describing 16 patients aged of 22-69 years old with a male predominance (sex ratio 4.3). Two patients (12.5%) had a well-documented clinical history of pituitary macroadenoma prior to the diagnosis of bacterial meningitis. Rhinorrhea has been found as the most common symptom through six patients (37.5%). Through the CSF culture, bacterial meningitis among patients suffering of pituitary macroadenoma commonly was due to Streptococcus pneumoniae. The examination in 18.75% of cases revealed signs related to pituitary macroadenoma (ophthalmoplegia and blindness). Six patients (37.5%) had received a treatment by dopaminergic agonist alone and 4 patients (25%) were treated with dopaminergic agonist associated with surgical treatment. Surgical treatment consisted of closure of the osteomeningeal breach in 12.5% (2/16) and tumor resection in 31.25% (5/16). Three patients (18.75%) had benefited tumor resection without prior agonist treatment. The mortality was 12.5% (2/16). Conclusion -Our systematic review shows that bacterial meningitis represents a rare initial symptom leading to the diagnosis of invasive pituitary macroadenoma.

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confidence: 46%

Section: Discussionmentioning

confidence: 99%