[Sarcoidosis: the involvement of anterior pituitary hormones is poorly recognized]

Hypothalamic-pituitary locations of sarcoidosis are rare. Achieving more systematic hormonal testing could increase the screening of such patients. The objective of this study was to evaluate the impact on the detection of hypothalamic-pituitary sarcoidosis in patients hospitalized for this condition in a lung disease sensibilized department.

In hormonology department, we collected and analyzed hormonal testing, from the list of patients hospitalized for pulmonary sarcoidosis in 2007-2008. Diabetes insipidus was defined clinically. The case of patients with multiple hormone deficiencies was analyzed for the diagnosis of hypothalamic-pituitary damage.

In a cohort of 486 patients, 158 (33%) had a hormonal abnormality. Forty-six of 158 patients (≈30%) had at least one pituitary deficiency or hyperprolactinemia: 31 adrenal insufficiency (isolated for 21), 20 gonadotrop deficiency, 14 hyperprolactinemia, 3 thyreotrop deficiency and a growth hormone deficiency. Among eight patients with association of hyperprolactinemia and hypogonadism, four have a probable diagnosis of hypothalamic-pituitary sarcoidosis, including 3 new cases.

Despite a selection bias (hospital patients, more severe forms), prevalence of hormonal abnormalities was higher than expected.

In the condition of this study, hypothalamic-pituitary affected 2.5% of patients with sarcoidosis in pneumologic department (4/158). Hormonal abnormalities were present in one third of hospitalized patients. The most prevalent deficiency found was corticotrope deficiency, secondary to corticosteroid therapy.