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Acute hypophysitis with pachymeningitis
Mayank Sahu1, Debabrata Chakraborty2, Suddhasatwya Chatterjee1
1Internal Medicine, Apollo Multispeciality Hospital, Kolkata, West Bengal, India.
BMJ Case Reports
|February 20, 2025
Summary
A rare case of IgG4-related hypophysitis and pachymeningitis presented as common symptoms like headache and fever. Prompt diagnosis requires broad clinical suspicion for uncommon conditions.
Area of Science:
- Neurology
- Endocrinology
- Immunology
Background:
- Common symptoms like headache, fever, and neck stiffness can mask rare underlying conditions.
- Diagnostic challenges arise when initial presentations mimic more prevalent diseases.
Purpose of the Study:
- To report a case of IgG4-related hypophysitis and pachymeningitis presenting with non-specific symptoms.
- To highlight the importance of maintaining a high index of suspicion for rare diagnoses.
Main Methods:
- Case report of an elderly woman with new-onset neck stiffness, headache, and fever.
- Systematic diagnostic workup to identify the cause of symptoms.
Main Results:
- The diagnostic process ultimately identified IgG4-related hypophysitis and pachymeningitis.
- Initial common differentials, including tuberculosis, were considered but ruled out.
Conclusions:
- Uncommon diagnoses like IgG4-related hypophysitis and pachymeningitis require prompt clinical suspicion.
- A thorough and timely diagnostic workup is crucial for identifying complex and rare conditions presenting with overlapping symptoms.
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