VISION LOSS DUE TO PITUITARY APOPLEXY: A RARE PRESENTATION OF DENGUE FEVER

Abstract

Introduction Pituitary apoplexy (PA) is an endocrine emergency resulting from hemorrhage or infarction within a pituitary tumor or non-tumorous pituitary gland. The most important predisposing factors for PA are cerebral angiographic procedures, systemic hypertension, surgeries, head injury, coagulopathies, and drugs. Thrombocytopenia is a risk factor for PA. Dengue fever causes thrombocytopenia and there are reporte Purpose d cases of dengue hemorrhagic fever and dengue fever without hemorrhagic manifestation predisposing to PA. But there are no reported cases of dengue fever per se predisposing to PA leading to early vision loss, and we report such a case of dengue fever leading to pituitary apoplexy in pre-existing macroadenoma. 30 year male patient without any past comorb Case idity presented with complaint of fever and headache since 2 days and came dengue ns1+ve on 3rd day of admission he developed worsening of headache and complete left sided ptosis and painful ophthalmoplegia, further workup and mri brain showed pituitary hemorrhage in underlying asymptomatic pituitary adenoma. With rapid deterioration patient lost vision in 2 days before surgical intervention was done. Pituitary apoplexy is a vision and potentially life threatening di Conclusion sorder with which every physician needs to be acquainted. Dengue fever with thrombocytopenia is potential risk factor for pituitary apoplexy. Prompt diagnosis and initiation of treatment is of utmost importance.