Lymphocytic hypophysitis in a man presenting with hypercalcemia.
A 59-year-old man with a 30-year history of type 2 diabetes mellitus presented with fatigue, confusion, and weight loss over a 3-month period. He was found to be hypercalcemic (11.8 mg/dL) and dehydrated, and his hypercalcemia improved with intravenous fluids. While in the hospital, he developed hyponatremia, hypoglycemia, and hypotension. He was found to have a subnormal cortisol level of 2.3 microg/dL at baseline, which increased to only 5.6 microg/dL 60 minutes after a 250-microg corticotropin intravenous stimulation test. The patient developed pneumonia and adult respiratory distress syndrome and died of an acute myocardial infarction. During the autopsy, he was found to have lymphocytic hypophysitis with a severe reduction in corticotropin-producing anterior pituitary cells. No malignancy was identified at autopsy. He is the first male patient to be described in the literature who presented with hypercalcemia caused by lymphocytic hypophysitis.
Department of Pathology, Harbor-UCLA Medical Center, Los Angeles, California, USA.
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L
Novoa-Takara
M
M
Cornford
C
C
Williams
J A
JA
Tayek
D001344:Autopsy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D006801:Humans; D006934:Hypercalcemia / Q000150:complications*; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D010900:Pituitary Diseases / Q000175:diagnosis*