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Nonsurgical Management of a Patient with Hypopituitarism Secondary to Nonfunctioning Pituitary Macroadenoma: A Case Report Martino Handoyo; Hermina Novida
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 4 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i4.16960

Abstract

Pituitary adenoma is a benign neoplasm of pituitary gland. Pituitary adenoma, particularly a macroadenoma,may produce mass effect symptoms by compressing surrounding tissues. Due to pituitary function as aneuroendocrine organ, pituitary adenoma may also cause multiple endocrine disturbances. The authors reportthe case of a 39-year-old male patient presenting with chronic headache and history of seizure. MRI imagingrevealed pituitary macroadenoma with optic chiasm compression. Further diagnostic workup indicatedsecondary hypogonadism and adrenal insufficiency. The patient was given hormone replacement therapyand was then advised for surgery, but the patient refused any surgical procedure. Subsequent follow-upswere somewhat difficult due to poor patient adherence. Nevertheless, appropriate management of pituitaryadenoma is needed to achieve optimal result.
Hepatic Hydrothorax in a Patient with Liver Cirrhosis: a Case Report Martino Handoyo; Titong Sugihartono
Current Internal Medicine Research and Practice Surabaya Journal Vol. 2 No. 2 (2021): CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cimrj.v2i2.28702

Abstract

Hepatic hydrothorax is a transudative pleural effusion which presents in 5-10% patients with liver cirrhosis. Although fairly uncommon, it is associated with higher morbidity and lower survival rate. The mechanism is yet to be understood fully, but the most widely accepted pathogenesis involves the presence of portal hypertension, diaphragmatic defects, and negative intrathoracal pressure, all of which lead to the formation of unidirectional passage of ascitic fluid from peritoneal cavity into pleural space. Due to its origin, the pleural effusion has similar characteristics to ascitic fluid. We herein report the case of a 60-year-old woman with advanced liver cirrhosis and right-sided moderate hepatic hydrothorax. Treatment given to the patient includes diuretics, sodium restriction, and repeated thoracentesis. Subsequent evaluation of the patient revealed improvement both clinically and radiologically.