Association d’une Maladie de Cushing et d’une Hyperprolactinémie Découverte en Contexte de Poussée Hypertensive
DOI :
https://doi.org/10.5281/hra.v2i2.5231Mots-clés :
Maladie de cushing, hyperprolactinémie, Double adénome hypophysaire, yaoundéRésumé
RÉSUMÉ
Introduction. L’association d’une maladie de cushing et d’une hyperprolactinémie est rare. Cette association peut être la résultante d’un double adénome hypophysaire ou d’un adénome mixte. Observation. Nous rapportons le cas d’une femme de 39 ans admise pour baisse brutale de l’acuité visuelle en contexte de poussée hypertensive et présentant un syndrome de Cushing ACTH dépendant associé à une hyperprolactinémie modérée asymptomatique. L’imagerie cérébrale a mis en évidence une image intrasellaire bilobée faisant suggérer la présence de deux adénomes distincts (corticotrope et lactotrope). Conclusion. Ce cas permet de sensibiliser sur la présentation clinique rare, sur le contexte de découverte atypique, les difficultés diagnostiques et l’importance d’une prise en charge multidisciplinaire des patients en endocrinologie.
ABSTRACT
Introduction. The association of Cushing's disease and hyperprolactinemia is rare. This association can result from a double pituitary adenoma or a mixed adenoma. Observation. We report the case of a 39-year-old woman admitted for a sudden decrease in visual acuity in the context of hypertensive crisis, and presenting with ACTH-dependent Cushing's syndrome associated with asymptomatic moderate hyperprolactinemia. Brain imaging revealed a bilobed intrasellar image suggesting the presence of two distinct adenomas (corticotrope and lactotrope). Conclusion. This case highlights the rare clinical presentation, atypical discovery context, diagnostic difficulties, and the importance of a multidisciplinary approach to patient management in endocrinology.
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