title: Hypopituitarism in a HIV affected patient.
abstract: BACKGROUND
  The clinical picture of pituitary abscesses may resemble features of other pituitary pathologies including endocrine deficiencies. The characteristic radiological changes, namely the ring enhancement, may aid in the diagnostic work-up of this very rare condition.
  
  
  METHODS
  A 40-year-old patient with longstanding HIV infection presented with headache and fatigue. Testing for pituitary function confirmed panhypopitutarism. MRI scanning demonstrated an inhomogeneous pituitary gland with ring-like enhancement and sphenoid sinus mucosa thickening. Transsphenoidal surgery was performed. Histologically CD68 positive macrophages were found supporting the diagnosis of infectious hypophysitis. Under hormone replacement therapy and retroviral treatment the patient clinically normalized.
  
  
  CONCLUSIONS
  A pituitary abscess due to infectious hypophysitis is a rare cause of pituitary failure. Diagnostic signs on imaging may help to rapidly distinguish the cause of pituitary deficiency in patients with HIV infection.
authors.affiliation: University Hospital of Lübeck, Department of Medicine, Lübeck, Germany. Birgit.Harbeck@uk-sh.de
authors.forename: B
authors.initials: B
authors.lastname: Harbeck
authors.forename: S
authors.initials: S
authors.lastname: Klose
authors.forename: M
authors.initials: M
authors.lastname: Buchfelder
authors.forename: G
authors.initials: G
authors.lastname: Brabant
authors.forename: H
authors.initials: H
authors.lastname: Lehnert
mesh_terms: D000038:Abscess / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005221:Fatigue / Q000209:etiology; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006261:Headache / Q000209:etiology; D020249:Hormone Replacement Therapy; D006801:Humans; D007016:Hypophysectomy; D007018:Hypopituitarism / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D010902:Pituitary Gland / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography; D016896:Treatment Outcome
chemical_list: D044966:Anti-Retroviral Agents