BRAIN and NERVE Shinkei Kenkyu no Shinpo Volume 71, Issue 6 (June 2019)

A Case of Flexion Contracture Associated with Hypopituitarism Hiroko Kitanosono 1,2 , Hirokazu Shiraishi 2 , Atsushi Nagaoka 2 , Shunsuke Yoshimura 2 , Yomi Nakajima 3 , Misa Imaizumi 3 , Takao Ando 3 , Akira Tsujino 2 1Department of Neurology, Isahaya General Hospital 2Department of Neurology and Strokology, Nagasaki University Hospital 3Department of Endocrinology and Metabolism, Nagasaki University Hospital Keyword: 汎下垂体機能低下症 , flexion contracture , Stiff-person症候群 , panhypopituitarism , Stiff-person syndrome pp.617-621
Published Date 2019/6/1
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A 72-year-old Japanese man developed progressive disturbance in ambulation with flexion contractures 5years before this admission. At 49 years of age, he was diagnosed with hypopituitarism after an operation for a Rathke's cleft. On admission, he could not fully extend his knees and hips because of painful muscle stiffness of the lower extremities. Initially, we suspected Stiff-person syndrome and initiated diazepam, which had no effect. Serum anti-glutamic acid decarboxylase antibody was negative. Next, we suspected flexion contractures associated with hypopituitarism. Endocrine evaluation revealed that ACTH, cortisol, and other hormone levels were lower than those reported in the previous evaluation. We treated the patient with hydrocortisone and his symptoms dramatically improved. It is rare for patients with hypopituitarism to have flexion contracture. This case suggests that we should consider hypopituitararism in the setting of flexion contractures.

(Received October 18, 2018; Accepted March 26, 2019; Published June 1, 2019)

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BRAIN and NERVE-神経研究の進歩
71巻6号 (2019年6月)
電子版ISSN 1344-8129 印刷版ISSN 1881-6096 医学書院