Lymphocytic hypophysitis with associated thyroiditis in a man with aseptic meningitis.

Pituitary
Sarina LimJohn V Conaglen

Abstract

Lymphocytic hypophysitis (LH) is a rare chronic inflammatory disorder characterized by lymphocytic infiltration of the pituitary gland commonly affecting women during pregnancy or post-partum period. The pathogenesis remains uncertain, however an autoimmune process is frequently implicated. There is limited data on the occurrence of LH outside the setting of autoimmunity. We describe a 37-year-old man presenting with diarrhoea, nausea, weight loss, low-grade fever, headache and cerebrospinal fluid analysis consistent with aseptic meningitis. Magnetic resonance imaging (MRI) demonstrated a homogenously enlarged pituitary gland with biochemical testing revealing partial hypopituitarism with adenocorticotrophic hormone and gonadotrophin deficiency. Notably, his free thyroid hormone levels were elevated with a suppressed thyroid-stimulating hormone and a suppressed thyroid technetium scan consistent with thyroiditis. Tissue antibodies including thyroid antibodies were negative. Following introduction of hydrocortisone, he developed transient diabetes insipidus which spontaneously resolved after 4 months. Thyrotoxicosis resolved after 5 weeks and thyroxine was commenced as he developed secondary hypothyroidism. Repeat MRI 3 months l...Continue Reading

References

Aug 1, 1987·Surgical Neurology·J A Vanneste, W Kamphorst
Mar 18, 2003·Pituitary·M P MattaP H Caron
May 2, 2003·Journal of the Royal Society of Medicine·Andreas K DemetriadesMichael Powell
Jun 14, 2003·Annals of Clinical Biochemistry·Mark W J StrachanAlan W Patrick
Oct 31, 2003·European Journal of Endocrinology·Antonio BellastellaAnnamaria De Bellis
Jan 7, 2005·Endocrine Reviews·Patrizio CaturegliNoel R Rose
Apr 14, 2005·Best Practice & Research. Clinical Endocrinology & Metabolism·Annamaria De BellisAntonio Bellastella
May 16, 2006·Journal of Endocrinological Investigation·E SonnetV Kerlan
Jun 24, 2006·European Journal of Endocrinology·Angelika GutenbergMichael Buchfelder

❮ Previous
Next ❯

Citations

Jun 30, 2009·Journal of Neurosurgery·Dibyendu Kumar RayJason P Sheehan

❮ Previous
Next ❯

Related Concepts

Related Feeds

Autoimmune Thyroiditis

Autoimmune thyroiditis is an inflammatory disease of thyroid gland due to autoimmune responses leading to lymphocytic infiltration of the gland. It is characterized by the presence of circulating thyroid antigen-specific T-cells and thyroid autoantibodies. Discover the latest research on autoimmune thyroiditis here.

Autoimmune Diseases

Autoimmune diseases occur as a result of an attack by the immune system on the body’s own tissues resulting in damage and dysfunction. There are different types of autoimmune diseases, in which there is a complex and unknown interaction between genetics and the environment. Discover the latest research on autoimmune diseases here.