Pituitary

An unusual cause of confusion and hyponatraemia in an elderly patient

Abstract

A large proportion of patients presenting on the acute medical take are frail and elderly and a significant proportion of these will have symptoms such as confusion, reduced mobility and electrolyte disturbances. These symptoms are typically attributed either to the iatrogenic effects of prescribed medications, disturbances in fluid balance and possible infective causes. We describe the case of a gentleman who presented with delirium, reduced mobility and hyponatraemia who was subsequently found to have pituitary failure secondary to pituitary apoplexy.

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Endocrine emergencies

Abstract

Endocrine emergencies are uncommon and require a high index of suspicion if they are to be managed appropriately. This is especially pertinent to physicians accepting emergency admissions to hospital. Treatment needs to be started prior to diagnostic confirmation. We outline the management of the following conditions that may present acutely: Thyroid emergencies - Myxoedema coma - Thyroid Storm Pituitary apoplexy Phaeochromocytoma crisis Acute adrenocortical insufficiency.

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