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Preparation of Mouse Pituitary Immunogen for the Induction of Experimental Autoimmune Hypophysitis
Published on: December 17, 2010
Lymphocytic hypophysitis masquerading as pituitary adenoma.
Rajneesh Mittal1, Pramila Kalra, Mala Dharmalingam
1Department of Endocrinology, MS Ramaiah Medical College, Bangalore, India.
Indian Journal of Endocrinology and Metabolism
|April 9, 2013
Summary
This case report details a rare presentation of lymphocytic hypophysitis (LH) in an adolescent girl, highlighting its unique mass effect and diagnostic challenges. Histopathology confirmed LH, guiding treatment and improving pituitary function, though diabetes insipidus persisted.
Area of Science:
- Endocrinology
- Neurology
- Pathology
Background:
- Pituitary hypophysitis (PH) involves inflammatory infiltration of the pituitary gland, potentially causing hypopituitarism.
- PH can be autoimmune or secondary to systemic conditions, with various histopathological subtypes including lymphocytic, granulomatous, and IgG4-related forms.
- Lymphocytic hypophysitis (LH) is the most common type, typically affecting young to middle-aged women, often in the postpartum period.
Observation:
- A 15-year-old female presented with headache, amenorrhea, and polyuria.
- Clinical evaluation revealed suppressed follicle-stimulating hormone, elevated prolactin, and diabetes insipidus.
- MRI showed a pituitary macroadenoma compressing the optic chiasm.
Findings:
- Surgical decompression yielded tissue consistent with lymphocytic hypophysitis.
- Postoperatively, menstrual cycles resumed, and prolactin normalized.
- Diabetes insipidus persisted, requiring desmopressin treatment.
Implications:
- This case underscores the rare occurrence of LH in adolescent females and its presentation as a mass-like lesion.
- Early diagnosis relies on histopathological examination for definitive LH identification.
- Treatment strategies for LH should integrate clinical suspicion and patient manifestations, with surgery potentially alleviating mass effects.
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