{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T17:22:23Z","timestamp":1762017743002},"reference-count":22,"publisher":"FapUNIFESP (SciELO)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq Bras Endocrinol Metab"],"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:p>Pituitary apoplexy is a rare but potentially life-threatening clinical syndrome characterized by ischemic infarction or hemorrhage into a pituitary tumor. The diagnosis of pituitary tumor apoplexy is frequently complicated because of the nonspecific nature of its signs and symptoms, which can mimic different neurological processes, including meningitis. Several factors have been associated with apoplexy, such as dopamine agonists, radiotherapy, or head trauma, but meningitis is a rarely reported cause. We describe the case of a 51-year-old woman with acromegaly due to a pituitary macroadenoma. Before surgical treatment, she arrived at Emergency with fever, nausea, vomiting and meningismus. Symptoms and laboratory tests suggested bacterial meningitis, and antibiotic therapy was initiated, with quick improvement. A computerized tomography (CT) scan at admission did not reveal any change in pituitary adenoma, but a few weeks later, magnetic resonance imaging (MRI) showed data of pituitary apoplexy with complete disappearance of the adenoma. Currently, her acromegaly is cured, but she developed hypopituitarism and diabetes insipidus following apoplexy. We question whether she really experienced meningitis leading to apoplexy or whether apoplexy was misinterpreted as meningitis. In conclusion, the relationship between meningitis and pituitary apoplexy may be bidirectional. Apoplexy can mimic viral or bacterial meningitis, but meningitis might cause apoplexy, as well. This fact highlights the importance of differential diagnosis when evaluating patients with pituitary adenomas and acute neurological symptoms.<\/jats:p>","DOI":"10.1590\/0004-2730000002701","type":"journal-article","created":{"date-parts":[[2014,3,31]],"date-time":"2014-03-31T15:11:48Z","timestamp":1396278708000},"page":"76-80","source":"Crossref","is-referenced-by-count":9,"title":["Spontaneous remission of acromegaly: apoplexy mimicking meningitis or meningitis as a cause of apoplexy?"],"prefix":"10.1590","volume":"58","author":[{"given":"Roc\u00edo","family":"Villar-Taibo","sequence":"first","affiliation":[{"name":"Complejo Asistencial Universitario de Le\u00f3n,  Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda D.","family":"Ballesteros-Pomar","sequence":"additional","affiliation":[{"name":"Complejo Asistencial Universitario de Le\u00f3n,  Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfonso","family":"Vidal-Casariego","sequence":"additional","affiliation":[{"name":"Complejo Asistencial Universitario de Le\u00f3n,  Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosa M.","family":"\u00c1lvarez-San Mart\u00edn","sequence":"additional","affiliation":[{"name":"Complejo Asistencial Universitario de Le\u00f3n,  Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgios","family":"Kyriakos","sequence":"additional","affiliation":[{"name":"Complejo Asistencial Universitario de Le\u00f3n,  Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isidoro","family":"Cano-Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Complejo Asistencial Universitario de Le\u00f3n,  Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","reference":[{"key":"ref1","first-page":"789","article-title":"Pathological report of a case of acromegaly, with special reference to the lesions in the hypophysis cerebri and in the thyroid gland: and a case of hemorrhage into the pituitary","volume":"1","author":"Bailey P","year":"1898","journal-title":"Philadelphia Med J"},{"issue":"4","key":"ref2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3171\/foc.2004.16.4.7","article-title":"Pituitary tumor apoplexy: characteristics, treatment, and outcomes","volume":"16","author":"Verrees M","year":"2004","journal-title":"Neurosurg Focus"},{"issue":"2A","key":"ref3","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1590\/S0004-282X2009000200033","article-title":"Pituitary tumor apoplexy","volume":"67","author":"Chang CV","year":"2009","journal-title":"Arq Neuropsiquiatr"},{"issue":"5","key":"ref4","doi-asserted-by":"crossref","first-page":"530","DOI":"10.4103\/0028-3886.103211","article-title":"Spontaneous disappearance of the pituitary macroadenoma after apoplexy: a case report and review of the literature","volume":"60","author":"Liu S","year":"2012","journal-title":"Neurol India"},{"issue":"7","key":"ref5","doi-asserted-by":"crossref","first-page":"725","DOI":"10.4158\/EP09126.CRR","article-title":"Remission of acromegaly after pituitary apoplexy: case report and review of literature","volume":"15","author":"Fraser LA","year":"2009","journal-title":"Endocr Pract"},{"issue":"11","key":"ref6","first-page":"967","article-title":"Spontaneous remission of acromegaly after meningitis: a case report","volume":"55","author":"Katsuno M","year":"2003","journal-title":"No To Shinkei"},{"issue":"4","key":"ref7","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1111\/j.1600-0404.1986.tb03519.x","article-title":"Pituitary apoplexy with sterile meningitis","volume":"74","author":"Bjerrre P","year":"1986","journal-title":"Acta Neurol Scand"},{"issue":"8","key":"ref8","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1007\/BF03347359","article-title":"Acute sterile meningitis as a primary manifestation of pituitary apoplexy","volume":"26","author":"Valente M","year":"2003","journal-title":"J Endocrinol Invest"},{"issue":"1","key":"ref9","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1111\/j.1526-4610.2004.04013.x","article-title":"Pituitary apoplexy masquerading as meningoencephalitis","volume":"44","author":"Jassal DS","year":"2004","journal-title":"Headache"},{"issue":"7","key":"ref10","doi-asserted-by":"crossref","first-page":"e7","DOI":"10.1111\/j.1468-1331.2007.01644.x","article-title":"Pituitary apoplexy after mild head injury misinterpreted as bacterial meningitis","volume":"14","author":"Smidt MH","year":"2007","journal-title":"Eur J Neurol"},{"issue":"2","key":"ref11","first-page":"65","article-title":"An interesting case of a pituitary adenoma apoplexy mimicking an acute meningitis. 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