Nikhil Prasad Fact checked by:Thailand Medical News Team Jun 08, 2025 1 week, 3 days, 13 hours, 50 minutes ago
Medical News: In an unusual medical case out of Romania, doctors have reported a rare pituitary gland bleed in a teenage boy that may be linked to a recent COVID-19 infection. This remarkable case not only highlights a potentially new complication of the SARS-CoV-2 virus but also showcases the life-changing benefits of a carefully planned hormone treatment strategy.
Possible Link Between COVID-19 and Rare Pituitary Bleed in Child
The research team behind this report hails from the Department of Endocrinology, Diabetes Mellitus, Nutrition and Metabolic Disorders at Carol Davila University of Medicine and Pharmacy and Elias Emergency University Hospital in Bucharest. Additional contributors include experts from the Pediatric Hospital in Ploiesti and the Department of Radiology and Medical Imaging at Elias Hospital.
Thailand
Medical News had already previously covered studies that indicated that both COVID-19 infections and COVID-19 vaccines could cause pituitary apoplexy and even pituitary adenomas and other pituitary gland issues.
https://www.thailandmedical.news/news/thailand-medical-news-warns-that-covid-19-infections-and-covid-19-vaccines-can-cause-pituitary-apoplexy-and-possibly-pituitary-adenomas
https://www.thailandmedical.news/news/italian-peer-reviewed-study-warns-that-covid-19-vaccines-are-triggering-various-pituitary-gland-disorders-in-many
https://www.thailandmedical.news/news/breaking-news-italian-study-reveals-that-sars-cov-2-is-able-to-affect-the-pituitary-gland-leading-to-possible-hypopituitarism-and-a-variety-of-disorde
https://www.thailandmedical.news/news/covid-19-news-physicians-warn-that-sars-cov-2-infections-can-also-lead-to-hypophysitis-based-on-a-case-study
This
Medical News report however focuses on a 13-year-old boy who was first brought to doctors for his short stature. Though born healthy and with no developmental delays, his height was significantly below the expected range for his age and parental background. Blood tests suggested some hormonal irregularities, including growth hormone (GH) deficiency. However, an MRI scan revealed something even more unexpected—a subacute hemorrhage in the pituitary gland, a condition known as
pituitary apoplexy.
A Rare Condition Made Rarer by Age
Pituitary apoplexy is extremely rare in children. It occurs when there's sudden bleeding or tissue death in the pituitary gland, often due to an underlying tumor. In adults, it can cause symptoms like sudden vision loss or severe headaches. In this case, however, the boy showed no such warning signs. His only issue was delayed growth, which was later attributed to hormone deficiencies likely caused by the pituitary bleed.
Further investigation ruled out other common causes of apoplexy such as blood clotting disorders, head trauma, or tumors. However, doctors noted that the boy had suffered a respiratory illness weeks before his MRI. While he was never tested for COVID-19 at the time, his blood later showed very high levels of antibodies against the virus, indicating a past infection. Given the timeline, researchers suspect a strong association between the COVID-19 infection and the pituitary hemorrhage.
COVID-19 and the Pituitary Gland
Though COVID-19 is primarily known for affecting the lungs, more recent research has shown the virus can also impact the nervous and endocrine systems. The virus uses the ACE2 receptor to enter cells, and these receptors are present in the pituitary gland. Several studies suggest that COVID-19 can trigger inflammatory and clotting responses in the body, potentially leading to conditions like pituitary apoplexy even without preexisting tumors.
In adults, similar cases have been reported where COVID-19 either directly damaged the pituitary or caused blood clots leading to hemorrhage. This report is the first known pediatric case where such a serious pituitary event may have been linked to SARS-CoV-2, even in the absence of tumors or known risk factors.
Aggressive and Innovative Treatment Pays Off
Once the diagnosis was made, doctors prescribed recombinant human growth hormone (rGH) therapy alongside an aromatase inhibitor called letrozole. Letrozole blocks estrogen, which helps delay bone growth plate closure, giving the GH therapy more time to work.
This strategy produced impressive results. Over 3 years and 10 months of careful monitoring and adjusted dosages, the boy’s height increased from 141 cm to 172.3 cm—nearly 10 cm taller than initial predictions and within the normal range for his age. His puberty progressed normally, and later MRI scans confirmed the resolution of the pituitary hemorrhage with no signs of tumors or cysts.
Why This Case Matters
This case is significant for several reasons. First, it documents a very rare instance of pediatric pituitary apoplexy without an identifiable tumor. Second, it raises important questions about COVID-19’s impact on children’s endocrine systems. Lastly, it demonstrates how a creative and individualized hormone therapy approach can result in near-complete recovery and normal growth.
Conclusions
The reported case provides compelling evidence that pituitary apoplexy, although rare in children, may occur without traditional risk factors and could potentially be triggered by a COVID-19 infection. While a direct causal link remains unproven due to the absence of a biopsy, the high antibody levels and absence of other causes strengthen this association. This case highlights the importance of considering COVID-19 as a possible factor in unexplained pediatric endocrine conditions. It also underscores the effectiveness of personalized growth hormone and aromatase inhibitor therapy in overcoming severe growth delays caused by endocrine disorders. Further research is essential to understand the full spectrum of COVID-19’s long-term effects on the pituitary gland and hormonal health in children.
The study findings were published in the peer reviewed journal: Diagnostics.
https://www.mdpi.com/2075-4418/15/12/1453
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Medical News.
Read Also:
https://www.thailandmedical.news/news/dysfunctions-in-the-vagus-nerve-hypothalamic-pituitary-adrenal-axis-and-mitochondria-underlie-the-complexities-of-long-covid
https://www.thailandmedical.news/news/breaking-german-and-swiss-study-discovers-sars-cov-2-targets-and-causes-cellular-damage-to-adrenal-glands-resulting-in-a-variety-of-health-conditions
https://www.thailandmedical.news/news/covid-19-news-italian-and-dutch-imaging-study-involving-18f-fdg-pet-ct-reveals-that-sars-cov-2-impairs-thyroid-and-adrenal-glands-functions
https://www.thailandmedical.news/articles/coronavirus
https://www.thailandmedical.news/pages/thailand_doctors_listings
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