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Histologically proven lymphocytic hypophysitis: spontaneous resolution and subsequent pregnancy
H Gagneja1, B Arafah, H C Taylor
1Division of Endocrinology, Fairview Health System and Case Western University School of Medicine, Cleveland, Ohio 44113, USA.
Mayo Clinic Proceedings
|March 9, 1999
Summary
This study presents a rare case of lymphocytic hypophysitis where a pituitary mass resolved with hydrocortisone therapy, enabling a successful pregnancy. This suggests conservative management may be viable for pituitary tumors without visual impairment.
Area of Science:
- Endocrinology
- Reproductive Medicine
- Oncology
Background:
- Lymphocytic hypophysitis is a rare inflammatory condition affecting the pituitary gland.
- Previous cases show variable outcomes regarding spontaneous regression and pregnancy.
- Histological confirmation is crucial for accurate diagnosis and management.
Observation:
- The study details a unique case of histologically confirmed lymphocytic hypophysitis.
- The patient presented with adrenocorticotropic hormone (corticotropin) and prolactin deficiencies.
- Pituitary mass regression occurred solely with physiologic hydrocortisone therapy.
Findings:
- A spontaneous pregnancy was achieved following successful treatment.
- No postpartum recurrence of the pituitary mass was observed.
- This case adds to the limited evidence supporting conservative management.
Implications:
- Conservative management, including withholding surgery and corticosteroids, may be safe for lymphocytic hypophysitis when visual defects are absent.
- Periodic reassessment is recommended for patients managed conservatively.
- This approach can preserve pituitary function and facilitate reproductive outcomes.