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Updated: Jul 25, 2026

Preparation of Mouse Pituitary Immunogen for the Induction of Experimental Autoimmune Hypophysitis
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[A case of lymphocytic hypophysitis initially diagnosed as aseptic meningitis]

Eito Miura1, Uran Komatsubara1, Yoshitaka Umeda1

  • 1Department of Neurology, Nagaoka Red Cross Hospital.

Rinsho Shinkeigaku = Clinical Neurology
|May 21, 2025
PubMed

Insights

A 57-year-old man with aseptic meningitis was diagnosed with atypical lymphocytic hypophysitis. This pituitary inflammation resolved with hormone replacement therapy, highlighting its importance in differential diagnosis.

Area of Science:

  • Endocrinology
  • Neurology
  • Immunology

Background:

  • Aseptic meningitis can present with non-specific symptoms like headache and fever.
  • Pituitary inflammation (hypophysitis) can lead to pan-hypopituitarism and neurological symptoms.
  • Distinguishing hypophysitis from other causes of meningitis is crucial for appropriate treatment.

Purpose of the Study:

  • To report a case of atypical lymphocytic hypophysitis presenting initially as aseptic meningitis.
  • To highlight the diagnostic challenges and the importance of pituitary imaging and hormonal evaluation.
  • To emphasize the effectiveness of hormone replacement therapy in managing hypophysitis.

Main Methods:

  • Clinical presentation and symptom exacerbation.
  • Cerebrospinal fluid (CSF) analysis for pleocytosis.
  • Brain magnetic resonance imaging (MRI) with gadolinium enhancement.
  • Comprehensive hormonal testing for pituitary function.
  • Exclusion of other inflammatory and infectious causes of hypophysitis.

Main Results:

  • The patient initially presented with symptoms suggestive of aseptic meningitis.
  • Brain MRI revealed pituitary gland enlargement extending to the stalk.
  • Hormonal tests confirmed pan-hypopituitarism.
  • Lymphocytic hypophysitis was diagnosed after excluding other conditions.
  • Hormone replacement therapy led to symptom improvement and pituitary gland size reduction.

Conclusions:

  • Atypical lymphocytic hypophysitis can mimic aseptic meningitis, especially when routine blood tests are normal.
  • Early pituitary imaging and hormonal assessment are vital for diagnosing hypophysitis in such cases.
  • Hormone replacement therapy is effective in managing symptoms and pituitary inflammation in lymphocytic hypophysitis.
Keywords:
aseptic meningitishypopituitarismlethargylymphocytic hypophysitis

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