title: Hypopituitarism associated with Cogan's syndrome; high-dose glucocorticoid therapy reverses pituitary swelling.
abstract: A 70-year-old woman with Cogan's syndrome first presented with central diabetes insipidus and then developed secondary hypothyroidism. Magnetic resonance imaging revealed a diffuse pituitary swelling without evidence of tumor. High-dose glucocorticoid therapy administered to treat Cogan's syndrome was very effective in suppressing the inflammatory process, and resulted in the reversal of the pituitary swelling and partial recovery of thyroid stimulating hormone secretion. This is the first case of hypopituitarism associated with Cogan's syndrome, a form of autoimmune vasculitis. The glucocorticoid-responsive pituitary lesion is best explained by autoimmune hypophysitis which shows pituitary swelling and is known to often associate with other autoimmune phenomena.
authors.affiliation: Third Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Kanatani
authors.forename: R
authors.initials: R
authors.lastname: Nakamura
authors.forename: K
authors.initials: K
authors.lastname: Kurokawa
authors.forename: M
authors.initials: M
authors.lastname: Taoda
authors.forename: Y
authors.initials: Y
authors.lastname: Nemoto
authors.forename: K
authors.initials: K
authors.lastname: Kamakura
authors.forename: N
authors.initials: N
authors.lastname: Kugai
authors.forename: N
authors.initials: N
authors.lastname: Nagata
authors.forename: O
authors.initials: O
authors.lastname: Takatani
authors.forename: K
authors.initials: K
authors.lastname: Tsuchiya
mesh_terms: D000368:Aged; D001327:Autoimmune Diseases / Q000150:complications*; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use; D003919:Diabetes Insipidus / Q000188:drug therapy / Q000209:etiology; D005158:Facial Paralysis / Q000209:etiology*; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000209:etiology; D007018:Hypopituitarism / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D008582:Meningitis, Aseptic / Q000209:etiology*; D010902:Pituitary Gland / Q000473:pathology; D011239:Prednisolone / Q000627:therapeutic use*; D013577:Syndrome; D014657:Vasculitis / Q000150:complications*; D015837:Vestibular Diseases / Q000209:etiology*
chemical_list: D011239:Prednisolone; D003894:Deamino Arginine Vasopressin