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January 1984

Spontaneous Hypoglycemic Seizures in Pregnancy: A Manifestation of Panhypopituitarism

Author Affiliations

From the Departments of Medicine (Ms Notterman and Drs Jovanovic and R. Peterson), Obstetrics and Gynecology (Dr Druzin), and Pediatrics (Dr Solomon), Cornell University Medical College, and The Rockefeller University (Dr C. M. Peterson), New York.

Arch Intern Med. 1984;144(1):189-191. doi:10.1001/archinte.1984.00350130219040

• A 32-year-old woman had seizures and coma due to severe hypoglycemia (26 mg/dL) in the 32nd week of an otherwise uncomplicated pregnancy. She responded dramatically to the administration of cortisol. Initial endocrine evaluation disclosed prolactin (PRL), corticotropin, and thyrotropin (TSH) deficiencies. The patient recovered completely with cortisol and thyroid hormone therapy and was delivered of a healthy male child at term. Endocrine reevaluations one week and six months postpartum disclosed luteinizing hormone, follicle-stimulating hormone, growth hormone, PRL, corticotropin, and probable TSH deficiencies. The cause of this panhypopituitarism has not been determined. This case suggests that the appropriate initial treatment for spontaneous symptomatic hypoglycemia in pregnancy, while awaiting further endocrine evaluation, is the administration of cortisol.

(Arch Intern Med 1984;144:189-191)