A Remote Cause of Vomiting: Case Report on Pan-Hypopituitarism

Pan-hypopituitarism is the inability of the pituitary gland to provide sufficient hormones due to an in sufficient supply of hypothalamic releasing hormones. A46 year old female patient was admitted to the department of gastroenterology with chief complaints history of vomiting since 4 months (5- 10 minfollowing feed), weakness and weight preserved. All Endo-crinological work up was not normal. MRI brain (PIT protocol)came with Empty sella with infundibulum central with flattened anterior pituitary.She had attained menopause at age of 30 years 3 -4 years following the birth of her 3rd female child. She had diagnosed with Empty Sella Syndrome, Anterior Pituitary Hypoplasia,and Sheehan’s Syndrome. Finallyshe was treated with prednisone 10mg (5mg at morning and 5mg at evening) and Levothyroxine 50 mcg daily before breakfast. Further workup with DEXA bone scans and plan hormone replacement Serial measurement of hormone assay.