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All Journal Jurnal Kesehatan Andalas Universa Medicina Jurnal Penelitian Pendidikan IPA (JPPIPA) Buletin Ilmiah Nagari Membangun Majalah Kedokteran Andalas Health and Medical Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research Scientific Journal Jurnal Ilmu Kesehatan Indonesia (JIKSI) Jurnal Pengabdian Masyarakat Kesehatan (JURABDIKES) Indonesian Journal of Endocrinology Metabolism and Diabetes (InaJEMD)
Alexander Kam
Bagian Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Andalas / RSUP Dr. M.Djamil, Padang
Agriculture, Biological Sciences & Forestry Humanities Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Chemistry Economics, Econometrics & Finance Education Engineering Environmental Science Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Nursing Physics Public Health Veterinary Other

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Atypical Presentation of Clinically Non-Functioning Pituitary Macroadenoma: Case Report of Concurrent Graves' Disease and Multi-Axis Pituitary Hypofunction in a 40-Year-Old Female Rizkha Amaliya; Dolly Irfandy; Hesty Lidya Ningsih; Alexander Kam; Mardijas Efendi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 6 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i6.1610

Abstract

Background: Non-functioning pituitary adenomas (NFPAs) present variable clinical manifestations depending on tumor size and location. Concurrent primary autoimmune thyroid disease in NFPA patients is exceptionally rare and requires careful diagnostic distinction from secondary hypothyroidism. Case presentation: A 40-year-old female presented with progressive bilateral peripheral vision narrowing over 3 months, chronic bifrontal headaches, secondary amenorrhea, and nocturia-predominant polyuria. Neuro-ophthalmologic examination revealed bitemporal hemianopsia with visual acuity 20/200 left eye and 20/25 right eye. Endocrine evaluation demonstrated: primary hyperthyroidism (TSH 0.02 µIU/mL, FT4 28.32 pmol/L, positive thyroid receptor antibodies), secondary adrenal insufficiency (cortisol 1 µg/dL, ACTH <5 pg/mL), and hypogonadotropic hypogonadism (LH 1.62 IU/L). Neuroimaging revealed a 2.13 × 2.28 × 3.05 cm sellar/suprasellar lesion with optic chiasm compression (Knosp Grade II). Endoscopic transsphenoidal surgery achieved complete gross total resection. Histopathology confirmed null-cell adenoma with low Ki-67 proliferation index (2%). Conclusion: Postoperative course was uncomplicated with rapid visual field improvement, complete resolution of bitemporal hemianopsia by 2 weeks, and normalization of all endocrine axes by 12 weeks, including menstrual recovery and gonadal axis restoration. This case illustrates the diagnostic challenge of distinguishing secondary hyperprolactinemia from primary prolactinoma in NFPA, the rarity of concurrent Graves' disease with pituitary macroadenoma, and favorable outcomes with complete surgical decompression achieving multisystem endocrine recovery.
Profil Risiko Diabetes dan Sindrom Metabolik Berdasarkan Indeks Massa Tubuh dan Glukosa Darah Sewaktu di Bukik Batabuah Dinda Aprilia; Eva Decroli; Alexander Kam; Yanne Pradwi Efendi; Athari Fadhila Namanda Putri
Abdika Sciena Vol 3 No 2 (2025): JURABDIKES Volume 3 No 2, Desember 2025
Publisher : CV. AKBAR PUTRA MANDIRI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56260/jurabdikes.v3i2.328

Abstract

Latar Belakang: Diabetes melitus (DM) dan sindrom metabolik merupakan masalah kesehatan global dengan peningkatan prevalensi setiap tahun. Indeks massa tubuh (IMT) dan kadar glukosa darah merupakan indikator penting dalam menilai risiko DM dan sindrom metabolik pada populasi komunitas. Tujuan: Mengetahui karakteristik indikator risiko DM dan sindrom metabolik berdasarkan IMT, GDS dan demografis masyarakat Bukik Batabuah tahun 2024. Metode: Penelitian deskriptif observasional terhadap 69 responden. Data yang dikumpulkan meliputi usia, jenis kelamin, IMT, kategori IMT, dan GDS. Analisis dilakukan secara deskriptif. Hasil: Rerata usia responden 50,93 tahun, dengan mayoritas perempuan (76,81%). Rerata IMT 23,23 kg/m² dengan 24,64% responden tergolong overweight–obesitas. Rerata GDS 130,59 mg/dL dengan nilai maksimum 337 mg/dL menunjukkan adanya risiko gangguan glukosa. Kesimpulan: Populasi Bukik Batabuah menunjukkan risiko metabolik yang ditandai dengan IMT di atas normal. Skrining komunitas dan intervensi promotif-preventif diperlukan  
Pituitary macroadenoma with optic chiasm compression and hypopituitarism: a case report Alexander Kam; Dinda Aprilia; Eva Decroli
Universa Medicina Vol. 45 No. 1 (2026)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2026.v45.81-87

Abstract

INTRODUCTIONPituitary macroadenomas are benign pituitary tumors measuring more than 1 cm in diameter that constitute a substantial proportion of intracranial neoplasms. Despite their benign histology, these tumors may lead to significant morbidity due to local mass effects and endocrine dysfunction. Compression of the optic chiasm can result in progressive visual impairment and irreversible blindness if not promptly treated. Additionally, pituitary hormonal deficiencies may cause life-threatening metabolic and systemic complications. Early recognition and multidisciplinary management are therefore essential to prevent permanent sequelae and optimize functional recovery. Case DescriptionA 40-year-old woman presented with a one-year history of recurrent headaches accompanied by progressive blurring of vision, diplopia, and visual field defects. She also reported irregular menstruation and unintended weight loss. Brain magnetic resonance imaging demonstrated a 2.13 × 2.28 × 3.05 cm pituitary macroadenoma with a characteristic “snowman appearance” compressing the optic chiasm. Hormonal evaluation revealed secondary adrenal insufficiency, hypogonadotropic hypogonadism, suppressed thyroid-stimulating hormone (TSH) with elevated free thyroxine (T4), and hyperprolactinemia attributed to the stalk effect, consistent with hypopituitarism and thyroid dysfunction. Initial stabilization with hydrocortisone and methimazole was performed prior to definitive management. The patient subsequently underwent transsphenoidal tumor resection with appropriate perioperative glucocorticoid coverage. Postoperatively, she remained clinically stable with improvement in headache and visual symptoms, and continued hormonal therapy under close endocrinological supervision. ConclusionsThis case underscores the importance of comprehensive hormonal assessment, timely neurosurgical intervention, and coordinated multidisciplinary care in managing pituitary macroadenomas complicated by optic chiasm compression and hypopituitarism to achieve favorable clinical outcomes.
Profil Metabolik pada Masyarakat Sijunjung: Studi Cross-Sectional Dinda Aprilia; Eva Decroli; Alexander Kam; Yanne Pradwi Efendi; Athari Fadhila Namanda Putri
Abdika Sciena Vol 4 No 1 (2026): JURABDIKES Volume 4 No 1, Juni 2026
Publisher : CV. AKBAR PUTRA MANDIRI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56260/jurabdikes.v4i1.376

Abstract

Latar Belakang: Penyakit tidak menular (PTM) seperti obesitas, diabetes melitus (DM), dislipidemia, dan hiperurisemia merupakan permasalahan kesehatan yang semakin meningkat prevalensinya di Indonesia, termasuk di daerah pedesaan. Desa Lansek Manih kabupaten Sijunjung sebagai salah satu daerah di Sumatera Barat memiliki akses terbatas terhadap fasilitas kesehatan sehingga deteksi dini terhadap faktor risiko metabolik menjadi sangat penting. Tujuan: Penelitian ini bertujuan untuk menggambarkan profil indeks massa tubuh (IMT), prevalensi diabetes melitus, kadar kolesterol, dan kadar asam urat pada masyarakat Desa Lansek Manih, Sijunjung. Metode: Penelitian ini merupakan studi deskriptif observasional dengan desain cross-sectional. Sebanyak 74 responden yang direkrut secara consecutive sampling dari kegiatan pengabdian masyarakat di desa Lansek Manih Sijunjung. Data yang dikumpulkan meliputi usia, jenis kelamin, indeks massa tubuh (IMT), status diabetes melitus, kadar kolesterol total, dan kadar asam urat. Hasil: Rerata usia responden adalah 49,62 tahun (18–70 tahun) dengan lebih banyak berjenis kelamin perempuan (57,97%). Rerata IMT sebesar 26,25 kg/m², dengan 62,16% responden termasuk kategori overweight dan obesitas. Sebanyak 12,16% responden terdiagnosis diabetes melitus. Rerata kadar kolesterol adalah 237 mg/dL dan rerata kadar asam urat adalah 6,12 mg/dL. Kesimpulan: Prevalensi overweight/obesitas, dislipidemia, dan diabetes melitus yang tinggi pada masyarakat desa Lansek Manih Sijunjung mengindikasikan perlunya program skrining dan intervensi dini terhadap faktor risiko metabolik di tingkat komunitas.
Two-Year Follow-Up of Parathyroid Hormone, Calcium, and Vitamin D Serum Levels in a Patient after Parathyroidectomy Alexander Kam; Dinda Aprilia; Eva Decroli; Syafril Syahbuddin
‎ InaJEMD - Indonesian Journal of Endocrinology Metabolism and Diabetes Vol. 2 No. 1 (2025): InaJEMD Vol. 2, No. 1
Publisher : PP PERKENI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.66266/inajemd.v2i1.37

Abstract

Parathyroidectomy is the definitive treatment for primary hyperparathyroidism. Because of the hungry bone syndrome and prolonged hypocalcemia risk, we must follow up on a patient's parathyroid hormone, calcium, and vitamin D serum after parathyroidectomy. In this case report, we reported on a parathyroidectomy patient whom we followed for two years and who, interestingly, had elevated parathyroid hormone levels. A 35-year-old male patient diagnosed with a left parathyroid tumor underwent parathyroidectomy and isthmolobectomy. The patient was treated with calcium, vitamin D, and levothyroxine supplementation. We diagnosed the patient with hungry bone syndrome on the fourth day of post-parathyroidectomy. Then, we documented calcium, vitamin D, and PTH levels in the next two years. The calcium levels are 7.2 (June 2022), 8.2 (July 2022), 8.5 (September 2022), 7.8 (October 2022), 8.1 (June 2023), 9.7 (June 2024). The PTH levels are 244.2 (June 2022), 328.3 (July 2022), 306.5 (September 2022), 457.2 (October 2022), 163.3 (June 2023), 34.4 (June 2024). The Vitamin D levels are 34.4 (July 2022), 13.4 (March 2023), 35.2 (September 2023), 50.4 (April 2024). We increased the dose of calcium and vitamin D supplementation. The patient is in good condition and has reached a normal level of these laboratory parameters in the second year post-parathyroidectomy. PTH, calcium, and vitamin D serum are needed for follow-up in patients after parathyroidectomy. Normalizing calcium and vitamin D serum is essential to maintaining a normal PTH level. Normal PTH, calcium, and vitamin D serum are the cure indications in this patient.
Pituitary Macroadenoma with Hypogonadism in 30 year old Liver Cirrhosis Patient: A Case Report Alexander Kam; Dinda Aprilia; Eva Decroli; Syafril Syahbuddin
‎ InaJEMD - Indonesian Journal of Endocrinology Metabolism and Diabetes Vol. 2 No. 1 (2025): InaJEMD Vol. 2, No. 1
Publisher : PP PERKENI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.66266/inajemd.v2i1.46

Abstract

Pituitary macroadenomas can suppress pituitary hormone secretion, one of which is the gonadotropin hormone, causing hypogonadism. The condition of hypogonadism can increase the risk of NAFLD, which can then become liver cirrhosis. A 30-year-old man came to the hospital with decreased consciousness and hematemesis melena. From physical examination, laboratory, and pituitary MRI, the patient was diagnosed with pituitary macroadenoma, hypogonadotropic hypogonadism, primary hypothyroidism, acute adrenal insufficiency, and liver cirrhosis. The patient was given hydrocortisone therapy, correction of electrolyte levels, hypoglycemia protocol, levothyroxine 100 mg/day, and management of hematemesis melena. After that, Sustanon 250 mg was given every two weeks intramuscularly. The patient went home in good condition and was planned for neurosurgery consultation for transsphenoidal resection. After the injection of Sustanon, the patient experienced increased penile length and testicular volume. The condition of hypogonadism in patients with pituitary macroadenoma can be a risk factor for NAFLD, which can then progress to liver cirrhosis. NAFLD and liver cirrhosis also can cause hypogonadism in men by several mechanisms. The patient has been well-managed and experienced clinical improvement.
Co-Authors Abdul Alim Rahimi Abdul Alim Rahimi Akbar Shiddiq Andry Kurniawan Arina Widya Murni Arnelis Arnelis Athari Fadhila Namanda Putri Athari Fadhila Namanda Putri Auliangi Tamayo Avino Mulana Fikri Avino Mulana Fikri Deka Viotra Dinda Aprilia Dolly Irfandy Drajad Priyono Dwitya Elvira, Dwitya Eva Decroli Eva Decroli Evelin Veronike Farhan Abdullah Fauzar Fauzar Fauzar Fauzar Fauzar Fauzar Fauzar Fauzar Fauzar Harun Harnavi Hesty Lidya Ningsih Jersivindo Ranazeri Jersivindo Ranazeri Jersivindo Ranazeri Jonggara Oktaviandra Siahaan Mardijas Efendi Muthia Faurin Nasrul Zubir Putri Deas Hadilofyani R. Ifan Arief Fahrurozi Raveinal Raveinal Raveinal Raveinal Rinita Amelia Rizkha Amaliya Robby Satria Putra Roza Kurniati Roza Kurniati Roza Kurniati Roza Kurniati Roza Kurniati Rudy Afriant Saptino Miro Suci Berlian Hemilton Syafril Syahbuddin Syafril Syahbuddin Vesri Yoga Yanne Pradwi Efendi Yanne Pradwi Efendi Zaki Mahmudi Dasril Zulkarnain Arsyad