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Pituitary apoplexy—a rare and unusual complication following viper bite

Ritwika Majumdar, Lina Mukherjee, Uttam Biswas, Chanchal Kumar Jana.


Envenomation resulting from snake bite is an important public health problem in tropical countries like South Asia and throughout Indian subcontinent. Snake bite is associated with myriad of complications that can be life threatening. Here, an 18 year old woman who was bitten by Russell's viper was reported and was treated with antivenom, other medications and supportive therapy like heamodialysis. Although the patient recovered from the acute effects, patient continued to remain unwell, developed amenorrhea, loss of axillary and pubic hair and was investigated and diagnosed 4 months later with hypopituitarism. Replacement started with essential hormones such as oral ethinyl estradiol/norgestrel and Levo- thyroxine. In this case report, it is discussed why it is important to evaluate for pituitary function in every patient who sustained a Russell’s viper bite.

Key words: Russell’s viper, hypopituitarism, partially empty sella

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