Objectives Pituitary apoplexy is a rare complication of Cushing’s disease (CD), especially in the paediatric age and even more rarely it can occur following anterior pituitary stimulation tests. Case presentation We report a case of a 14-year-old girl who was admitted to our Hospital for evaluation of a possible Cushing’s syndrome (CS). Her symptoms and initial laboratory tests were suggestive of CD. Magnetic resonance imaging (MRI) revealed a microadenoma of the pituitary gland. As part of her evaluation she was submitted to a corticotropin-releasing hormone (CRH) stimulation test. Two and a half months later the patient was re-evaluated and presented with both clinical improvement of CS, biochemical resolution of hypercortisolism and tumour size reduction in the MRI, also evidencing a haemorrhagic component favouring the diagnosis of pituitary apoplexy after CRH stimulation test. The patient denied any episodes of severe headache, nausea, vomiting or visual changes. Conclusions To our knowledge, the authors report the first case of a pituitary apoplexy after a CRH stimulation test in the paediatric age.

中文翻译：

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促肾上腺皮质激素释放激素诱发的14岁库欣病女孩无症状垂体中风

目的垂体中风是库欣病 (CD) 的一种罕见并发症，尤其是在儿科时期，在垂体前叶刺激试验后更罕见。病例介绍 我们报告了一个 14 岁女孩的病例，她因评估可能的库欣综合征 (CS) 而入院。她的症状和最初的实验室检查提示 CD。磁共振成像 (MRI) 显示脑垂体微腺瘤。作为评估的一部分，她接受了促肾上腺皮质激素释放激素 (CRH) 刺激试验。两个半月后，患者接受了重新评估，并表现出 CS 的临床改善、皮质醇增多症的生化消退和 MRI 中肿瘤大小的减小，还证明了在 CRH 刺激试验后有利于诊断垂体卒中的出血成分。患者否认有任何严重头痛、恶心、呕吐或视力改变。结论 据我们所知，作者报告了首例儿科 CRH 刺激试验后垂体卒中的病例。