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Diagnosis and Treatment > Signs and Symptoms

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Dured Dardari Diabetology Department, Centre Hopitalier Sud Francilien, Corbeil-Essonnes, France
Sorbonne Université, Paris, France

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Alfred Penfornis Diabetology Department, Centre Hopitalier Sud Francilien, Corbeil-Essonnes, France
Paris-Sud Medical School, Paris-Saclay University, Orsay, France

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Agnes Hartemann Diabetology Department, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
Sorbonne Université, Paris, France

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Summary

We report the onset of acute Charcot neuroarthropathy during pregnancy in two patients with type 1 diabetes using retrospective review of case notes. We describe for the first time the onset of acute Charcot neuroarthropathy during pregnancy in two patients with type 1 diabetes. Pregnancy may promote the onset and worsening of a number of diabetic complications. A link between pregnancy and the onset of acute Charcot neuroarthropathy is demonstrated for the first time in this report.

Learning points:

  • Patients with already diagnosed sensitive neuropathy can develop an active phase of Charcot neuroarthropathy during pregnancy.

  • The rapid correction of hyperglycaemia may induce an active phase of Charcot neuroarthropathy during pregnancy.

Taxonomy:
Clinical Overview, Gland/Organ, Bone, Topic, Bone, Hormone, Insulin, Condition/ Syndrome, Diabetes mellitus type 1, Diabetic nephropathy, Hyperglycaemia, Thyroiditis, Patient Demographics, Age, Adult, Gender, Female, Ethnicity, White, Country of Treatment, France, Diagnosis and Treatment, Signs and Symptoms, Diabetes mellitus type 1, Diabetic neuropathy, Diabetic nephropathy, Feet - increased size, Hyperglycaemia, Microalbuminuria, Oedema, Paraesthesia, Retinopathy, Vomiting, Investigation, Albumin, Haemoglobin A1c, Ultrasound scan, Medication, Corticosteroids, Iron supplements, Insulin, Prednisone, Related Disciplines, Podiatry, Publication Details, Case Report Type, Insight into disease pathogenesis or mechanism of therapy
DOI:
https://doi.org/10.1530/EDM-20-0002
Volume/Issue:
Volume 2020: Issue 1
Open access
Gulay Simsek Bagir Departments of Endocrinology

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Soner Civi Departments of Endocrinology

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Ozgur Kardes Departments of Endocrinology

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Fazilet Kayaselcuk Departments of Endocrinology

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Melek Eda Ertorer Departments of Endocrinology

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Summary

Pituitary apoplexy (PA) may very rarely present with hiccups. A 32-year-old man with classical acromegaloid features was admitted with headache, nausea, vomiting and stubborn hiccups. Pituitary magnetic resonance imaging (MRI) demonstrated apoplexy of a macroadenoma with suprasellar extension abutting the optic chiasm. Plasma growth hormone (GH) levels exhibited suppression (below <1 ng/mL) at all time points during GH suppression test with 75 g oral glucose. After treatment with corticosteroid agents, he underwent transsphenoidal pituitary surgery and hiccups disappeared postoperatively. The GH secretion potential of the tumor was clearly demonstrated immunohistochemically. We conclude that stubborn hiccups in a patient with a pituitary macroadenoma may be a sign of massive apoplexy that may result in hormonal remission.

Learning points:

  • Patients with pituitary apoplexy may rarely present with hiccups.

  • Stubborn hiccupping may be a sign of generalized infarction of a large tumor irritating the midbrain.

  • Infarction can be so massive that it may cause cessation of hormonal overproduction and result in remission.

Taxonomy:
Clinical Overview, Gland/Organ, Pituitary, Topic, Pituitary, Hormone, GH, LH, Prolactin, Testosterone, TSH, Condition/ Syndrome, Acromegaly, Pituitary adenoma, Pituitary apoplexy, Patient Demographics, Age, Adult, Gender, Male, Ethnicity, Asian - other, Country of Treatment, Turkey, Diagnosis and Treatment, Signs and Symptoms, Dehydration, Feet - increased size, Fingers - thick, Headache, Hypotension, Nausea, Singultus, Vomiting, Investigation, GH, GH suppression, Histopathology, Immunohistochemistry, LH, MRI, Prolactin, Testosterone, TSH, Intervention, Fluid repletion, Resection of tumour, Transsphenoidal surgery, Medication, Corticosteroids, Glucocorticoids, Related Disciplines, Surgery, Publication Details, Case Report Type, Unique/unexpected symptoms or presentations of a disease
DOI:
https://doi.org/10.1530/EDM-17-0044
Volume/Issue:
Volume 2017: Issue 1
Open access