A post menopausal female with empty sella syndrome

Empty sella syndrome is an incidental anatomical finding which can occasionally present as hypopituitarism. Here we report a post-menopausal female with emptysella syndrome and anterior pituitary hormone deficiency. She is a 69 year-old mother of four children presented with progressively worsening lethargy and constipation. Her last pregnancy at 24 years was complicated with post-partum haemorrhage. She had breastfed her last child for an year. She attained menopause at the age of 45. Investigations revealed normocytic anemia, and hyponatremia. Hormonal profile showed a normal TSH level(2.09mu/l)and low free T4 (<0.07 ng/dl) suggestive of secondary hypothyroidism. She also had low level of 9am cortisol, and inappropriately low FSH and LH levels. Non-contrast computerized tomography of the brain revealed cerebrospinal fluid(CSF) within sella-turcica, suggestive of empty-sella syndrome. She was treated with replacement doses of hydrocortisone and thyroxine and with that her symptoms improved.