The course of lymphocytic hypophysitis.
A 27-year-old woman presented to our institution in her seventh month of pregnancy with complaints of headache and visual field disturbance. Workup revealed bitemporal hemianopia, a markedly enlarged pituitary gland on computed tomography scan, and biochemical evidence of partial hypopituitarism. At surgery, a biopsy specimen of the pituitary gland was taken revealing lymphocytic hypophysitis. The patient was treated with steroids and replacement doses of thyroid hormone. Visual fields improved postoperatively. A repeat computed tomography scan obtained 2 months after an uneventful pregnancy showed that her pituitary had regained normal size and contour. Over the next 9 months she had gradual recovery of all pituitary function. This case allowed us to follow and document the course of lymphocytic hypophysitis from its presentation as a macroadenoma with partial hypopituitarism to full recovery of both size and hormonal function of the pituitary. Lymphocytic hypophysitis should be considered in the differential diagnosis of a pituitary mass or pituitary dysfunction presenting in pregnancy. In patients with suspected lymphocytic hypophysitis and a pituitary mass, a trial of steroids may be therapeutic.
Bitton
R N
RN
Department of Medicine (Division of Endocrinology), Long Island Jewish Medical Center, New Hyde Park, New York 11042.
Slavin
M
M
Decker
R E
RE
Zito
J
J
Schneider
B S
BS
D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007249:Inflammation / Q000473:pathology / Q000601:surgery; D008214:Lymphocytes; D010900:Pituitary Diseases / Q000473:pathology / Q000601:surgery; D010903:Pituitary Gland, Anterior; D011247:Pregnancy; D011248:Pregnancy Complications / Q000473:pathology / Q000601:surgery; D011263:Pregnancy Trimester, Third