A progressive case of lymphocytic hypophysitis accompanied by paresis of the left abducens nerve

We describe a rare and interesting progressive case of lymphocytic hypophysitis accompanied later by paresis of the left abducens nerve. A 42-year-old woman was diagnosed as having lymphocytic hypophysitis accompanied by diabetes insipidus and hypopituitarism. She had no symptoms of visual disturbance at that time. She was not treated with steroids because she is a carrier of the hepatitis B virus. Later, in 2006, she complained of progression of symptoms and double vision for a few months. Her pituitary gland showed further enlargement. The patient was diagnosed as having progressive lymphocytic hypophysitis accompanied by paresis of the left abducens nerve, which was subsequently confirmed by biopsy. The progression of lymphocytic hypophysitis in patients not receiving steroid therapy should be carefully monitored.