Severe back pain, depression and psycho-organic syndrome.
Sir,

Altered mental activity is a common symptom of hypopituitarism. The most frequent causes of acquired hypopituitarism are pituitary tumors, empty sella, infiltrative or vascular disorders or cranial radiation therapy. We describe a patient with a classical clinical presentation and laboratory findings for a hypopituitarism, but with an extremely rare aetiology.

A 69-year-old woman was referred to the clinic in May 2000 because of progressive debilitation, depression and psycho-organic syndrome. In May 1999, a peridural catheter was placed for continuous administration of morphine (2.5 mg/day) to relieve long-lasting, severe lumbo-vertebral pain of degenerative origin. Since the autumn of 1999, the patient had fallen into a progressive condition of generalized tiredness, inactivity, depression, and mental confusion. On examination, she was debilitated and …