Heparin-Induced Pituitary Apoplexy Presenting as Isolated Unilateral Oculomotor Nerve Palsy: A Case Report and Literature Review
Joint Authors
Bachuwa, Ghassan
Swaid, Bakr
Kalaba, Frank
Sullivan, Stephen E.
Source
Issue
Vol. 2019, Issue 2019 (31 Dec. 2019), pp.1-5, 5 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2019-10-09
Country of Publication
Egypt
No. of Pages
5
Main Subjects
Abstract EN
Introduction.
Pituitary apoplexy (PA) is a rare and potentially life-threatening clinical syndrome resulting from pituitary gland hemorrhage and/or infarction.
Anticoagulation is a risk factor for triggering PA.
Isolated oculomotor nerve palsy is an atypical presentation of PA.
Case Presentation.
A 65-year-old African American female with no past medical history of pituitary disease presented to the emergency department (ED) with nonspecific abdominal pain that was thought to be secondary to fecal stasis and subsequently improved with laxatives.
She also reported atypical chest pain that was concerning for unstable angina.
She was started on aspirin, clopidogrel, and intravenous (IV) heparin.
Later, coronary catheterization showed no significant coronary artery disease (CAD).
Twelve hours after the procedure, the patient developed acute complete left oculomotor nerve palsy with a severe headache.
Magnetic resonance imaging (MRI) of the head showed a large pituitary mass.
Pituitary apoplexy was suspected and the patient eventually underwent a successful trans-sphenoidal pituitary resection.
Discussion.
We report a case of PA manifesting as isolated left oculomotor nerve palsy without visual field defects in the setting of using dual antiplatelet therapy (DAPT) and IV heparin for acute coronary syndrome.
To the best of our knowledge, this unique combination has not been previously reported.
American Psychological Association (APA)
Swaid, Bakr& Kalaba, Frank& Bachuwa, Ghassan& Sullivan, Stephen E.. 2019. Heparin-Induced Pituitary Apoplexy Presenting as Isolated Unilateral Oculomotor Nerve Palsy: A Case Report and Literature Review. Case Reports in Endocrinology،Vol. 2019, no. 2019, pp.1-5.
https://search.emarefa.net/detail/BIM-1135757
Modern Language Association (MLA)
Swaid, Bakr…[et al.]. Heparin-Induced Pituitary Apoplexy Presenting as Isolated Unilateral Oculomotor Nerve Palsy: A Case Report and Literature Review. Case Reports in Endocrinology No. 2019 (2019), pp.1-5.
https://search.emarefa.net/detail/BIM-1135757
American Medical Association (AMA)
Swaid, Bakr& Kalaba, Frank& Bachuwa, Ghassan& Sullivan, Stephen E.. Heparin-Induced Pituitary Apoplexy Presenting as Isolated Unilateral Oculomotor Nerve Palsy: A Case Report and Literature Review. Case Reports in Endocrinology. 2019. Vol. 2019, no. 2019, pp.1-5.
https://search.emarefa.net/detail/BIM-1135757
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1135757