Snake Envenomation: A Rare Cause of Hypopituitarism - A Case Report

Authors

  • Harshita Lachhwani Shri Ram Murti Smarak Institute of Medical Sciences

Keywords:

snakebite, hypopituitarism

Abstract

BACKGROUND: Snake bites are frequent in a developing country like India, especially rural areas. Mostly they are minor and never reported but sometimes they may be serious and fatal. Occasionally, Viper bites induced hemorrhagic complications land the patient into hypovolemic shock, leading to Sheehan’s syndrome-like condition and causing panhypopituitarism. The onset of features of panhypopituitarism may be delayed by a few years.

THE CASE: With this background, we are presenting a case of a 27-year-old male who presented to us in April 2022 with a history of reduced growth of facial hair, which was normal a few years back, along with associated symptoms of polyuria, polydipsia, polyphagia, and cold intolerance. Most importantly, he gave a history of a viper bite in 2017 for which he was hospitalized in a state of hypovolemic shock. At the time of presentation to us, his BP was 96/64 mm Hg, and pulse was 70/min. His investigations showed low T3, T4, TSH, low testosterone, reduced levels of Sr FSH, Sr LH, and Sr Prolactin. His 24-hour urine volume was 2.8 L, his testicular volume was low, and MRI Brain showed empty Sella. He was managed conservatively with oral hydrocortisone, levothyroxine tablets, and injectable testosterone. He has been under our follow-up for the last 2 years and has responded well to the treatment both symptomatically and in terms of blood parameters.

CONCLUSION: Hypopituitarism is a rare complication of snake bite. Therefore, it is important to undergo relevant hormonal tests in persons who have a history of snake bite in the past.

Metrics

Metrics Loading ...

References

REFERENCES

Eapen CK, Chandy N, Kochuvarkey KL, Zacharia PK, Thomas PJ, Ipe TI, 1976. Unusual complication of snake bite:

hypopituitarism after viper bites. Ohsaka A, Hayashi K, Sawai Y, Murata R, Funatsu M, Tamiya N, eds. Animal, Plant, and Microbial

Toxins. New York, NY: Springer, 467–473. [Google Scholar]

Tun-Pe , Phillips RE, Warrell DA, Moore RA, Swe TN, Lwin M, Burke CW, 1987. Acute and chronic pituitary failure resembling Sheehan’s

syndrome following bites by Russell’s viper in Burma. Lancet 2: 763–767. [PubMed] [Google Scholar]

Burke CW, 1990. The anterior pituitary, snakebite and Sheehan’s syndrome. Q J Med 75: 331–333. [PubMed] [Google Scholar]

Antonypillai CN, Wass JaH, Warrell DA, Rajaratnam HN, 2011. Hypopituitarism following envenoming by Russell’s vipers (Daboia

siamensis and D. russelii) resembling Sheehan’s syndrome: first case report from Sri Lanka, a review of the literature and

recommendations for endocrine management. QJM 104: 97–108. [PubMed] [Google Scholar]

Downloads

Published

2025-01-01

How to Cite

Lachhwani, H. (2025). Snake Envenomation: A Rare Cause of Hypopituitarism - A Case Report. International Journal of Medical Students, 12, S387. Retrieved from https://ijms.info/IJMS/article/view/2921

Issue

Section

Abstracts of the WCMSR

Categories