A case of apoplectic lymphocytic hypophysitis complicated by polymyalgia rheumatica.
A case of apoplectic lymphocytic hypophysitis complicated by polymyalgia rheumatica (PMA) is described. A 72-year-old man was admitted to our hospital due to severe headache. Two months prior to admission, the patients had exhibited recent-onset stiffness and myalgia of shoulder and pelvic girdle that was compatible with PMR. Magnetic resonance imaging revealed a mass lesion in the pituitary fossa with focal hemorrhage. Endocrinologic studies demonstrated hypopituitarism. The headache and myalgia were improving with corticosteroid treatment; however, a trans-sphenoidal surgery was performed due to visual field loss. A white-colored mass was resected, and histologic examination showed diffuse infiltration of lymphocytes and plasma cells consistent with lymphocytic hypophysitis. Post-operatively, the headache and visual field loss resolved completely. This is the first documented case of apoplectic lymphocytic hypophysitis complicating PMR, and a possible mechanism for this rare association was discussed.
Department of Rheumatology and General Internal Medicine, NHO National Nagasaki Medical Center, Kubara 2-1001-1 Omura, Nagasaki 856-8562, Japan.
Yasuko
Y
Tanaka
Tomohito
T
Hirao
Keisuke
K
Tsutsumi
Taiichiro
T
Miyashita
Yasumori
Y
Izumi
Yumi
Y
Mihara
Masahiro
M
Ito
Hiroshi
H
Baba
Kiysohi
K
Migita
D000368:Aged; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007016:Hypophysectomy; D007018:Hypopituitarism / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D007249:Inflammation / Q000150:complications / Q000473:pathology / Q000628:therapy; D008214:Lymphocytes / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D010899:Pituitary Apoplexy / Q000150:complications* / Q000473:pathology / Q000628:therapy; D010902:Pituitary Gland / Q000473:pathology / Q000601:surgery; D011111:Polymyalgia Rheumatica / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D016896:Treatment Outcome
D005938:Glucocorticoids