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[Pituitary tuberculosis: a case report].

L Trabelsi1, N Majdoub-Rekik, H Bouaziz

  • 1Service d'Endocrinologie, CHU Hédi Chaker, Sfax, Tunisie.

Annales D'Endocrinologie
|January 6, 2006
PubMed
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Pituitary tuberculosis, though rare, can cause central diabetes insipidus and hormonal imbalances. Early diagnosis and multi-drug antitubercular chemotherapy with supportive care lead to complete resolution of pituitary tuberculoma.

Area of Science:

  • Endocrinology
  • Infectious Diseases
  • Neurology

Background:

  • Pituitary tuberculoma is a rare manifestation of extrapulmonary tuberculosis.
  • It can present with diverse endocrine and neurological symptoms, mimicking other sellar region pathologies.

Observation:

  • A 42-year-old woman with a history of erythema nodosum presented with polyuria, polydipsia, amenorrhea, and galactorrhea.
  • Endocrine evaluation revealed central diabetes insipidus, hyperprolactinemia, and cortisol deficiency.
  • MRI showed a pituitary lesion with characteristic findings suggestive of tuberculosis.

Findings:

  • Diagnosis was confirmed by positive tuberculin skin test and Mycobacterium tuberculosis in bronchial fluid, excluding other sellar masses.
  • Treatment with a 4-drug antitubercular regimen followed by a 2-drug regimen, along with hormone replacement and bromocriptine, was initiated.

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  • Clinical symptoms resolved, and follow-up MRI demonstrated complete resolution of the pituitary lesion.

    • Implications:

    • Pituitary tuberculosis requires a high index of suspicion for accurate diagnosis, especially in endemic areas.
    • Prompt diagnosis and appropriate antitubercular therapy are crucial for favorable outcomes and complete cure.
    • This case highlights the importance of considering tuberculosis in the differential diagnosis of sellar and suprasellar masses.