title: An Atypical Case of Lymphocytic Panhypophysitis in a Pregnant Woman.
abstract: We describe a case of lymphocytic panhypophysitis (LPH) in a 30-year-old woman presenting with throbbing headaches and vision changes during her third trimester. LPH is the rarest subclassification of lymphocytic hypophysitis; it is typically found in males and has not previously been associated with pregnancy. Anterior and posterior pituitary deficits together with headaches should raise a high degree of suspicion regarding the possibility of LPH. The atypical magnetic resonance imaging finding of a heterogeneous pituitary mass additionally raised concern about pituitary apoplexy. Tissue from a transsphenoidal biopsy permitted diagnosis of lymphocytic hypophysitis. There was infiltration of the pituitary gland by small B and T lymphocytes. Resolution of the visual symptoms occurred after the biopsy and treatment with intravenous steroids.
authors.affiliation: Department of Ophthalmology (ECD, JFR), Neuro-Ophthalmology Service, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Department of Ophthalmology (ECD, FAJ, AMS), David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; and Department of Ophthalmology (ECD, FAJ, AMS, JFR), Harvard Medical School, Boston, Massachusetts.
authors.forename: Emma C
authors.initials: EC
authors.lastname: Davies
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Jakobiec
authors.forename: Anna M
authors.initials: AM
authors.lastname: Stagner
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Rizzo
mesh_terms: D000328:Adult; D000069281:Autoimmune Hypophysitis / Q000150:complications / Q000175:diagnosis*; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D010902:Pituitary Gland / Q000473:pathology*; D011247:Pregnancy; D011248:Pregnancy Complications; D011263:Pregnancy Trimester, Third; D012607:Scotoma / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology*