Pituitary Problem

Hi,

My name is Luciano and I am from Brazil. I need some help to diagnosis a possible pituitary problem. Here in Brazil the doctors say the problem is not there, but I want an expert international opinion. Could you help me? I know that just a email can´t give you all the details, but I am glad of any information.


Is my former wife, she is a Brazilian, 40 years, works as a teacher. About 5'4" and 98 kg. Actually I think is more water (swelling) than fat.

Symptoms:

She has sleep problems (changes night/day, nowadays a lot of sleepiness); suffers from a metabolic syndrome, fat mass, glucose intolerance, high blood pressure peaks, some hypoglycemia; a major swelling (mostly feet and legs); Sweats a lot or no sweats, no matter if is hot or cold; she is with memories problems, mainly short-term, sometime acts dizzy; she has bunion and is getting worse, in fact her feet moved 7,5 to 8,5 (for her is only because the bunion, for me her feet is growing up at all) besides she has a back pain and the orthopedist said that is because a extra bone in the back – and she never noticed that (a new one?);



Some labs:

-Liver: Her liver is not ok, have a serious steatosis and the numbers are Ferritin 147, Gama GT 44, TGO 66 and TGP 102.

- She always have bad numbers in prolactin, the last was 40.5.

- The T4 levels are always close to the limit, yesterday the T4 free was 0.81. She uses levothyroxine sodium, 75mgc

- PCR test. 14.9 mg/L !!!
- DEHIDROEPIANDROSTERONA, SULPHET 34.2 microg/dL

- All cancer marks were negative.
- She had tested for dozens of hormones and
elements, if you want to know more I can send later.

She had a RMI in 2013, they found a small cyst (3mm) on the pituitary. All doctors said it is so small to damage the pituitary. But the symptoms were there. And nowadays all symptoms are worst. She repeated the RMI, the results are below.

Thank You,

Luciano Basso



PS: I wrote this originally in Portuguese and translated very quickly, I apologize for orthographic and grammar errors.









RM SADDLE / Pituitary



Method: Examination with FSE sequences in T1 in the coronal and sagittal planes, with 1.7 and 2.5 mm in width, after administration of intravenous paramagnetic contrast (gadolinium).

Study supplemented with cuts in T2, the ESF sequence in the plan coronal.

Held FLAIR sequence in the axial plane for further evaluation of brain.



Analysis:



Seal cavity shape and dimensions preserved.

Compatible with a small cyst in protein content, characterized by isosignal T1 and hypointense on T2 marked measuring about 0.3 cm, interposed between the anterior and posterior lobes of hypophysis.

Posterior lobe of topography and intensity of normal signal.

Pituitary stalk centered and preserved caliber.

Suprasellar cistern free.

Optic chiasm uncompressed signals.

Cavernous sinus and opaque with no apparent injury.



OPINION:

Findings consistent with small cyst pars intermedia, displaying high protein content.



There were characterized changes to the inspection of a 11/07/2013.



Note: Rare hyperintense foci on FLAIR white matter supratentorial, nonspecific. Small arachnoid cyst in the fossa left middle cranial. Dig the persistence of the septum pellucidum and vergae (anatomical variation). Tweet