Acute endocrine presentations in general practice

Acute presentation of a pituitary adenoma

Natassia Rodrigo, Bernard Champion, Christian Girgis



A 68-year-old man reports nonspecific symptoms including lethargy, reduced appetite, low libido, new postural hypotension and an episode of severe headache associated with vomiting. How do you investigate and manage this patient?

Article Extract

John, a 68-year-old Caucasian man, is a new patient to your practice and has recently moved into the area. He presents to you complaining of a one-month history of nonspecific symptoms including lethargy, reduced appetite and low libido. Four weeks ago, he experienced a severe headache affecting his frontal region, which was associated with vomiting. This headache episode lasted three days and was not associated with any antecedent trauma or localising neurological deficit. He did not seek medical attention at the time and attributed his symptoms to the recent stress of moving. More recently, he has experienced occasional postural dizziness, particularly on standing quickly and on rising each morning.

Picture credit: © Mehau Kulyk/SPL