Russell's viper (Daboia russelii) envenomation may be complicated by pituitary hypofunction, including the empty sella syndrome.
Patient selection: snakebite from Russell's viper
Distribution: rural areas of South and Southeast Asia
Mechanism: vasculotoxic venom
Clinical features:
(1) pituitary necrosis and/or infarction at the time of the snake bite
(2) hypopituitarism with hormonal deficiency (thyroid, adrenal, growth hormone, other) noted weeks or months later
(3) MRI changes in the sella
