Background: Pituitary apoplexy is a life-threatening endocrine emergency that is caused by haemorrhage or infarction of the pituitary gland, commonly within a pituitary adenoma. Patients classically present with headache, ophthalmoplegia, visual field defects and altered mental state, but may present with a typical symptoms such as fever and altered conscious level. Case presentation: A 57-year-old female with a known pituitary macroadenoma was treated for suspected acute coronary syndrome with aspirin, clopidogrel and full dose enoxaparin. She developed a severe and sudden headache, nausea and vomiting and visual deterioration. A CT scan showed haemorrhage into the pituitary macroadenoma. She underwent neurosurgical decompression. Post-operatively her visual fields and acuity returned to baseline. She was continued on hydrocortisone and thyroxine replacement on discharge. Conclusion: This case illustrates the risks of anticoagulation in a patient with a known pituitary macroadenoma, and raises the issue of whether these tumours present a relative contraindication to the use of dual antiplatelet and anticoagulation in acute coronary syndrome. © 2007 Tan et al; licensee BioMed Central Ltd.
CITATION STYLE
Tan, T. M. M., Caputo, C., Mehta, A., Hatfield, E. C. I., Martin, N. M., & Meeran, K. (2007). Pituitary macroadenomas: Are combination antiplatelet and anticoagulant therapy contraindicated? A case report. Journal of Medical Case Reports, 1. https://doi.org/10.1186/1752-1947-1-74
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