Sir, This report presents an unusual case of hypopituitarism following snake envenomation. There are many causes of hypopituitarism, commonest being pituitary tumors.A 25-year-old female presented with amenorrhea of 5 years duration. The patient had history of snake bite 5 years back on the left foot followed by swelling of the left leg, facial puffiness, abdominal distension, oliguria, hematuria and altered sensorium. Subsequently the patient had renal failure and had hemodialysis for the same. Since then the patient developed amenorrhea, poor appetite, cold intolerance, excessive sleepiness and generalized tiredness. Laboratory parameters were: T4 0.42 jAg/d, T3 0.195 jAg/ml, thyroid stimulating hormone 5.34 |nIU/ml, luteinizing hormone 0.72 IU/L, follicle-stimulating hormone 2.09 mlU/ml, prolactin 3.15 ng/ml and cortisol 32.67 nmol/1. Magnetic resonance image (MRI) showed sella filled with cerebrospinal fluid [Figure la] and a very thin rim of soft-tissue along the floor of sella [Figures lb and 2a].
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机译：主席先生，本报告介绍了蛇毒后垂体功能低下的罕见情况。垂体功能低下的原因有很多，最常见的是垂体瘤。一名25岁女性表现为闭经5年。该患者有5年左脚蛇咬伤史，随后出现左腿肿胀，面部浮肿，腹胀，尿少，血尿和感觉改变。随后，患者患有肾衰竭，并进行了血液透析。从那以后，患者发展为闭经，食欲不振，耐寒，过度嗜睡和全身疲倦。实验室参数为：T4 0.42 jAg / d，T3 0.195 jAg / ml，甲状腺刺激素5.34 | nIU / ml，促黄体生成素0.72 IU / L，促卵泡激素2.09 mlU / ml，催乳素3.15 ng / ml和皮质醇32.67 nmol / 1。磁共振图像（MRI）显示蝶鞍充满了脑脊液[图1a]，沿蝶鞍底部的软组织边缘非常薄[图1b和2a]。
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