Inefficiency of the anticoagulant therapy in the regression of the radiation-induced optic neuropathy in Cushing's disease

• Type: Article in International Scientific Journal
• Date: 1999

Authors

Barbosa, AP (Author) Other; Carvalho, Davide (Author) Other; Marques, L (Author) Other; Monteiro, M (Author) Other; Neves, AC (Author) Other; Carvalho, AM (Author) Other; Cruz, J (Author) Other; Medina, JL (Author) Other

Journal

Title: Journal of Endocrinological Investigation

Vol. 22

Pages: 301-305

ISSN: 0391-4097

Publisher: Springer Nature

Indexing

ISI Web of Knowledge - 19 Citations

Scopus - 20 Citations

Other information

Authenticus ID: P-001-4QP

DOI: 10.1007/bf03343560

Abstract (EN): Radiation-induced optic neuropathy is a rare complication (prevalence less than 1%) following radiotherapy of the sellar region. However, the vasculopathy in Cushing's disease predisposes to radiation-induced injury. We report the case of a 24-year-old man with Cushing's disease since he was 16. The hormonal study including bilateral inferior petrosal sinus catheterization diagnosed a pituitary right lesion, but imagiology was always negative. He underwent a transsphenoidal microadenomectomy and the pathological study showed the presence of corticotrophic hyperplasia but no adenoma. Secondary hypothyroidism and hypogonadism as well as permanent diabetes insipidus were diagnosed and because the patient was not cured he underwent a second transsphenoidal total hypophysectomy. After that and because he was still hypercortisolemic, pituitary external irradiation was given in a total dose of 6000 rad. Six months later he developed progressive bilateral visual loss. Cerebral MR revealed focal enhancement of the enlarged optic nerves and chiasm, associated with demyelination areas of the posterior visual pathways. Treatment was tried first with high doses of corticosteroids and later with anticoagulants-heparin EV. 1000 U/h during 7 days followed by warfarin, but unsuccessfully, probably because the patient was already amaurotic at the beginning of the last treatment. (J. Endocrinol. Invest. 22: 301-305, 1999) (C)1999, Editrice Kurtis.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 5