title: Lymphocytic hypophysitis accompanied by aseptic meningitis mimics subacute meningoencephalitis.
abstract: A 66-year-old man was admitted to our hospital with muscle pain, fatigue and appetite loss that had lasted for a month. The patient was somnolent and had nuchal stiffness with a high fever. Cerebrospinal fluid (CSF) tests demonstrated lymphocytic pleocytosis with a decreased CSF-blood glucose ratio. The tests for tuberculous, fungal and carcinomatous meningitis and herpetic meningoencephalitis were negative. Endocrinological exams showed hypopituitarism and diabetes insipidus. A pituitary MRI showed an enlargement of the pituitary stalk. A diagnosis of lymphocytic hypophysitis with aseptic meningitis was made after the exclusion of secondary hypophysitis. Lymphocytic hypophysitis with aseptic meningitis can mimic subacute meningoencephalitis.
authors.affiliation: Department of Neurology, Dokkyo Medical University, Japan. keisuke@dokkyomed.ac.jp
authors.forename: Keisuke
authors.initials: K
authors.lastname: Suzuki
authors.forename: Naoki
authors.initials: N
authors.lastname: Izawa
authors.forename: Toshiki
authors.initials: T
authors.lastname: Nakamura
authors.forename: Kenichi
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Keita
authors.initials: K
authors.lastname: Ouchi
authors.forename: Hideki
authors.initials: H
authors.lastname: Sakuta
authors.forename: Yohei
authors.initials: Y
authors.lastname: Asakawa
authors.forename: Ayaka
authors.initials: A
authors.lastname: Numao
authors.forename: Koichi
authors.initials: K
authors.lastname: Hirata
mesh_terms: D000368:Aged; D015897:Comorbidity; D003919:Diabetes Insipidus / Q000175:diagnosis; D003937:Diagnosis, Differential; D006801:Humans; D007018:Hypopituitarism / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008297:Male; D008582:Meningitis, Aseptic / Q000175:diagnosis* / Q000453:epidemiology*; D008590:Meningoencephalitis / Q000175:diagnosis*; D010900:Pituitary Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D010902:Pituitary Gland / Q000473:pathology / Q000503:physiopathology