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Lymphocytic hypophysitis. Case report.

A Ruelle1, D Bernasconi, G Tunesi

  • 1Divisione di Neurochirurgia, Ospedale Galliera, Genova.

Journal of Neurosurgical Sciences
|May 19, 2000
PubMed
Summary
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Lymphocytic hypophysitis, a rare autoimmune condition, can affect women and men. This case highlights a 50-year-old woman with hypopituitarism, emphasizing surgical intervention for diagnosis and treatment.

Area of Science:

  • Endocrinology
  • Neuroimmunology
  • Radiology

Background:

  • Lymphocytic hypophysitis (LYH) is an uncommon inflammatory disorder affecting the pituitary gland.
  • While often associated with pregnancy, LYH can occur in non-pregnant women and men.
  • Autoimmune conditions, like erythema nodosus, may precede or coexist with LYH.

Observation:

  • A 50-year-old woman presented with a five-year history of erythema nodosus and subsequent hypopituitarism.
  • Symptoms included headache, amenorrhea, and rapidly progressive hypopituitarism.
  • Magnetic resonance imaging revealed a sellar mass with homogeneous enhancement, lacking posterior pituitary hyperintensity.

Findings:

  • The clinical presentation and MRI findings raised suspicion for hypophysitis.

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  • The lesion's growth and lack of response to steroid therapy indicated further intervention.
  • Surgical exploration was deemed necessary for both diagnosis and treatment.

    • Implications:

    • This case underscores the importance of considering LYH in patients with pituitary masses and autoimmune histories.
    • Early diagnosis and appropriate management, potentially including surgery, are crucial for improving outcomes.
    • Further research into the pathogenesis and optimal treatment strategies for LYH is warranted.