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A relapsing remitting lymphocytic hypophysitis.

M P Matta¹, M Kany, M B Delisle

¹Service d'Endocrinologie et Maladies Metaboliques, CHU Rangueil, Toulouse, France.

|March 18, 2003

Summary

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Lymphocytic hypophysitis, a rare pituitary disease, can manifest as recurrent aseptic meningitis. This case highlights the unpredictable nature and varied presentations of this autoimmune condition.

Area of Science:

Endocrinology
Neurology
Immunology

Background:

Lymphocytic hypophysitis (LH) is a rare autoimmune disorder affecting the pituitary gland, often presenting as a mass lesion with resulting pituitary insufficiency.
The unpredictable clinical course and limited treatment experience contribute to challenges in managing LH.

Observation:

A 45-year-old woman presented with recurrent fever, meningeal symptoms, and pituitary insufficiency.
Initial treatment with hydrocortisone led to regression of pituitary hypertrophy, but symptoms recurred two years later.
Cerebrospinal fluid analysis indicated aseptic lymphocytic meningitis, and pituitary biopsy confirmed LH.

Findings:

The patient experienced recurrent aseptic meningitis as an unusual presentation of lymphocytic hypophysitis.

Related Experiment Videos

Treatment with high-dose prednisone resulted in clinical and radiological improvement, with sustained symptom remission.

Long-term follow-up revealed an empty sella turcica on MRI.

Implications:

This case expands the known spectrum of clinical presentations for lymphocytic hypophysitis.
It underscores the importance of considering LH in patients with recurrent meningitis and pituitary dysfunction.
The findings suggest that immunosuppressive therapy may be effective in managing complex or recurrent cases of LH.