Hypothalamic-pituitary sarcoidosis. A case report.
A 42-year-old woman suffered from sarcoidosis and hypothalamic-pituitary involvement. When she presented initially, an abnormal chest radiograph and abnormal features on histological examination of the lymph nodes, which showed caseating granulomas, suggested a diagnosis of tuberculosis. Failure to respond to antituberculosis therapy and the progressive development of symptoms of both posterior and anterior pituitary deficiency prompted a review of the initial diagnosis. Subsequent dynamic tests of hypothalamic and pituitary function indicated lesions at both the hypothalamic and pituitary levels. Further tests, including the Kveim reaction, favoured a diagnosis of sarcoidosis. This case illustrates the uncommon association of caseating granulomas with sarcoidosis and documents hypopituitarism due to combined hypothalamic and pituitary disease caused by sarcoid infiltration.
D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007018:Hypopituitarism / Q000209:etiology; D007027:Hypothalamic Diseases / Q000175:diagnosis*; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology; D010900:Pituitary Diseases / Q000175:diagnosis*; D012507:Sarcoidosis / Q000150:complications / Q000175:diagnosis*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis