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Hypopituitarism due to CNS Aspergillus Infection
Shogo Funakoshi1, Mitsuru Nishiyama1,2, Masahiro Komori3
1Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi University, Japan.
Internal Medicine (Tokyo, Japan)
|March 10, 2024
Summary
This case report details a patient with central nervous system (CNS) aspergillosis presenting with hypopituitarism. Notably, adrenocorticotropic hormone (ACTH) secretion appeared relatively preserved, offering new insights into pituitary dysfunction.
Area of Science:
- Neuroendocrinology
- Infectious Diseases
- Radiology
Background:
- Central nervous system (CNS) infections can impact pituitary function.
- Aspergillosis is a fungal infection that can rarely affect the CNS.
- Hypopituitarism presents with deficiencies in multiple pituitary hormones.
Observation:
- A 59-year-old man presented with hyponatremia and was diagnosed with panhypopituitarism.
- Imaging revealed a pituitary lesion and a fungal mass in the sphenoid sinus, consistent with CNS aspergillosis.
- The patient received hydrocortisone for hyponatremia and antifungal treatment for aspergillosis.
Findings:
- Treatment with hydrocortisone resolved the patient's hyponatremia.
- Antifungal therapy led to improvement in the patient's overall condition and control of CNS lesions.
- This case is the first to suggest preserved adrenocorticotropic hormone (ACTH) secretion in Aspergillus-induced hypopituitarism.
Implications:
- CNS aspergillosis can cause hypopituitarism with potentially preserved ACTH function.
- Early diagnosis and treatment of CNS fungal infections are crucial for pituitary health.
- Further research is warranted to understand the mechanisms of selective pituitary hormone preservation in fungal infections.
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