Abstract
A 55-year-old woman undergoing neurosurgery for pituitary adenoma at age 19 underwent hormone replacement therapy that she later quit. She was diagnosed with diabetes mellitus at 48 years but declined routine medical care. At 55 years, she was hospitalized to control poorly controlled diabetes (HbA1c 10.8%).
On admission, she had hyperlipidemia and liver dysfunction. Hormone stimulation tests showed low GH, T3, PRL, LH, and FSH response and she was diagnosed with hypopituitarism. Concerning liver dysfunction, abdominal ultrasonography and computed tomography showed liver deformation, splenomegaly, and splenorenal shunt. Viral hepatitis and alcoholic and autoimmune liver disease were excluded as liver dysfunction etiology. Liver biopsy, yielded a diagnosis of non-alcoholic steatohepatitis (NASH) with liver cirrhosis. Glycemic control improved in diet therapy and insulin aspart injection before each meal. Inadequate long-term hormone replacement therapy after pituitary surgery appeared to cause NASH and progressive liver cirrhosis.
