Panhypopituitarism and adrenal crisis may mimic a case of septic shock, to begin with, and diagnosis is sometimes difficult. A definitive diagnosis is crucial for a successful outcome. Generalized weakness associated with symptoms such as drowsiness, altered sensorium, and easy fatigability are the common presentations in patients presenting to the emergency department. The symptoms may be related to the nervous system (central as well as peripheral), metabolic disorders, electrolytes, endocrinopathy, infectious diseases, toxins, trauma, etc. Early recognition with prompt management helps in preventing life-threatening complications.
We describe a case of a 50-year-old female who presented with drowsiness and generalized weakness which initially appeared as a septic shock but on detailed workup was found to be suffering from hypopituitarism. In the laboratory, the workup patient was found to be having decreased levels of pituitary hormones which were suggestive of hypopituitarism. In this case, presented here, the magnetic resonance imaging (MRI) of the brain was suggestive of “empty sella.” It is a rare disorder and patients with empty sella may be asymptomatic or present with one or more pituitary hormone deficiencies. The patient was treated with hormone replacement therapy to which the patient responded well and progressively improved.
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