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Hoffmann, R. A wiki for the life sciences where authorship matters. Nature Genetics (2008)
 

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Acute and chronic pituitary failure resembling Sheehan's syndrome following bites by Russell's viper in Burma.

Pituitary function was investigated in 9 patients in shock after Russell's viper bites and in 24 individuals who had been severely envenomed 2 weeks to 24 years previously. 3 out of 9 patients had hypoglycaemia and inappropriately low serum cortisol, plasma growth hormone, and plasma prolactin concentrations. 4 who died had pituitary haemorrhage and 1 had adrenal haemorrhage as well. Of the 24 who had apparently recovered from bites, 7 had clinical features of hypopituitarism and no response in plasma growth hormone or prolactin concentrations to symptom-producing insulin-induced hypoglycaemia. 4 of these 7 had a sluggish serum cortisol response to 'Synacthen Depot' and 5 had an abnormal cortisol response to hypoglycaemia. 4 men with symptoms who were tested had low serum testosterone concentrations; serum thyroxine was also low in these men but not in 2 women with menstrual disturbances and impaired insulin responses. Of the 17 individuals without clinical evidence of endocrine disease, 4 had pituitary hormonal abnormalities. Russell's viper envenoming may thus produce a disorder resembling Sheehan's syndrome.[1]

References

  1. Acute and chronic pituitary failure resembling Sheehan's syndrome following bites by Russell's viper in Burma. Tun-Pe, n.u.l.l., Phillips, R.E., Warrell, D.A., Moore, R.A., Tin-Nu-Swe, n.u.l.l., Myint-Lwin, n.u.l.l., Burke, C.W. Lancet (1987) [Pubmed]
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