Myopathy secondary to adrenal insufficiency in a patient with syndrome empty sella syndrome

Authors

  • María del Mar Bermejo-Olano Servicio de Medicina Interna, Hospital Universitario Fundación Alcorcón, Alcorcón (Madrid), Spain
  • Elena López-Hernández Servicio de Endocrinología y Nutrición, Hospital Universitario Fundación Alcorcón, Alcorcón (Madrid), Spain
  • José Luis Dobato-Ayuso Servicio de Neurología, Hospital Universitario Fundación Alcorcón, Alcorcón (Madrid), Spain
  • María Almudena Martínez-Pérez Servicio de Neurología, Hospital Universitario Fundación Alcorcón, Alcorcón (Madrid), Spain
  • Sergio Donnay-Candil Servicio de Endocrinología y Nutrición, Hospital Universitario Fundación Alcorcón, Alcorcón (Madrid), Spain

DOI:

https://doi.org/10.32818/reccmi.a5n1a7

Keywords:

adrenal insufficiency, muscular diseases, empty sella syndrome, glucocorticoids.

Abstract

A 21 year-old female requests medical assistance for asthenia and proximal lower limbs weakness. Through a blood test and electromyogram, it is stated that she has high CPK levels with signs of myopathy. After completing the study, she is diagnosed secondary adrenal insufficiency with regard to empty sella syndrome. As an atypical finding, the presence of positive anti-adrenal cells antibodies is highlighted. Af- ter establishing treatment of oral hydroaltenose, a progressive improvement has been detected until the complete solution of the clinical symptoms, as well as the normalization of the CPK levels and the electromyographic study.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Charmandari E, Nicolaides NC, Chrousos GP. Adrenal insufficiency. Lancet. 2014; 383(9935): 2152-2167. https://doi.org/10.1016/S0140-6736(13)61684-0.

Harbuz V, Bihan H, Salama J, Reach G, Cohen R. Flexion contractures possibly reflect the existence of hypocortisolism: two case reports. J Neurol. 2010; 257(7): 1129-1133. https://doi.org/10.1007/s00415-010-5477-8.

Anton E. Hypopituitarism due to primary empty sella and uncommon muscular symptoms. Rheumatol Int. 2012; 32(2): 565-566. https://doi.org/10.1007/s00296-010-1753-2.

Calañas-Continente AJ, López-Velasco R, Vega-López O, Vila-Dupla MJ, Alonso-Sánchez N, Rodríguez-García V. Sintomatología neuromuscular como forma de presentación de panhipopituitarismo. Endocrinol Nutr. 2000; 47(1): 31.

Hellesen A, Bratlanda E, Husebye ES. Autoimmune Addison’s disease–An update on pathogenesis. Ann Endocrinol (Paris). 2017. https://doi.org/10.1016/j.ando.2018.03.008.

Chiloiro S, Giampietro A, Bianchi A, Tartaglione T, Capobianco A, Anile C, et al. Diagnosis of endocrine disease: primary empty sella: a comprehensive review. Eur J Endocrinol. 2017; 177(6): R275-R285. https://doi.org/10.1530/EJE-17-0505.

De Marinis L, Bonadonna S, Bianchi A, Maira G, Giustina A. Primary empty sella. J Clin Endocrinol Metab. 2005; 90(9): 5471-5477. https://doi.org/10.1210/jc.2005-0288.

Mendonca BB, Osorio MG, Latronico AC, Estefan V, Lo LS, Arnhold IJ. Longitudinal hormonal and pituitary imaging changes in two females with combined pituitary hormone deficiency due to deletion of A301,G302 in the PROP1 gene. J Clin Endocrinol Metab. 1999; 84(3): 942-945. https://doi.org/10.1210/jcem.84.3.5537.

Published

2020-04-30

How to Cite

1.
Bermejo-Olano M del M, López-Hernández E, Dobato-Ayuso JL, Martínez-Pérez MA, Donnay-Candil S. Myopathy secondary to adrenal insufficiency in a patient with syndrome empty sella syndrome. Rev Esp Casos Clin Med Intern [Internet]. 2020 Apr. 30 [cited 2024 Dec. 26];5(1):18-20. Available from: https://www.reccmi.com/RECCMI/article/view/462