High altitude-induced pituitary apoplexy

Brar KS, Garg MK
Correspondence: Dr (Col) Brar KS, ksbrar32@hotmail.com

ABSTRACT
Sudden ascent to high altitudes beyond 2,438 m can cause life-threatening complications such as acute mountain sickness and high altitude cerebral and pulmonary oedema. We present a case of pituitary apoplexy in a young man who ascended to high altitude gradually, after proper acclimatisation. He developed headache, nausea, vomiting and persistent hypotension. Magnetic resonance imaging revealed an enlarged pituitary gland with haemorrhage. His hormonal estimation showed acute adrenal insufficiency due to corticotropin deficiency. The patient responded well to conservative medical management with hormonal replacement therapy. This is most likely the first reported case of high altitude-induced pituitary apoplexy in the literature.

Keywords: acute adrenal insufficiency, high-altitude illnesses, pituitary apoplexy
Singapore Med J 2012; 53(6): e117–e119