Raju PV¹,
Jagadeesan M¹,
Halleys Kumar¹,
Magesh Kumar S¹,
Hemachandrika C²
¹Department of General Medicine, Saveetha Medical College Hospital, Saveetha University, Chennai, Tamil Nadu, India,
²Department of Physiology, Kilpauk Medical College, Affiliated to the Tamil Nadu Dr.MGR Medical University, Chennai, Tamil Nadu, India

Abstract

• A 55 year old female patient presented with history of giddiness and fatigue of one year duration. She had pallor, diffuse hyperpigmentation of skin and mucosal surfaces, low blood pressure (90/60 mm Hg), hypoglycemia, hyponatremia (118 mEq/L), hypokalemia (2.7 mEq/L) and elevated serum ACTH levels (21 pmol/L) suggestive of hypocortisolism. On imaging, MRI Brain showed features suggestive of an empty sella. In the absence of any other inciting factors, a diagnosis of Primary Empty Sella (PES) syndrome was made. The patient was treated with levothyroxine, steroids, hypertonic saline and potassium supplements following which she recovered rapidly. An empty sella occurs due to herniation of the arachnoid membrane through an incompetent diaphragma sellae. Primary empty sella syndrome is considered as a less common entity and is usually asymptomatic and can be an incidental finding.
• Keywords: empty sella, Empty Sella Syndrome, hypopituitarism, pituitary dysfunction