title: Rapid exacerbation of lymphocytic infundibuloneurohypophysitis.
abstract: BACKGROUND
  Lymphocytic hypophysitis is a relatively rare autoimmune disease defined by lymphocytic infiltration to the pituitary. Its rarity and wide spectrum of clinical manifestations make clarification of the pathology difficult. Here, we describe a case we examined from the primary diagnosis to final discharge, showing the serial progression of lymphocytic infundibuloneurohypophysitis (LINH) to panhypopituitarism with extrapituitary inflammatory invasion in a short period, and responding favorably to high-dose glucocorticoid treatment.
  
  
  METHODS
  Polyuria, General fatigue and Nausea/Vomiting.
  
  
  METHODS
  Central diabetes insipidus (CDI), Lymphocytic infundibuloneurohypophysitis (LINH).
  
  
  METHODS
  Desmopressin acetate, High-dose glucocorticoid (GC) treatment.
  
  
  RESULTS
  He was prescribed desmopressin acetate and subsequently discharged. A month later, he revisited our hospital with general fatigue and nausea/vomiting. A screening test disclosed hypopituitarism with adrenal insufficiency. MRI revealed expanded contrast enhancement to the peripheral extrapituitary lesion. He received high-dose GC treatment and the affected lesion exhibited marked improvement on MRI, along with the recovery of the anterior pituitary function.
  
  
  CONCLUSIONS
  This case demonstrates the potential for classical LINH to develop into panhypopituitarsim. We consider this is the first documentation of approaching the cause of atypical LINH with progressive clinical course from the pathological viewpoint.
authors.affiliation: Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, Japan Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya, Japan. Department of Neurosurgery, Graduate School of Medicine, Kyoto University, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, Japan.
authors.forename: Kimitaka
authors.initials: K
authors.lastname: Shibue
authors.forename: Toshihito
authors.initials: T
authors.lastname: Fujii
authors.forename: Hisanori
authors.initials: H
authors.lastname: Goto
authors.forename: Yui
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Sugimura
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tanji
authors.forename: Akihiro
authors.initials: A
authors.lastname: Yasoda
authors.forename: Nobuya
authors.initials: N
authors.lastname: Inagaki
mesh_terms: D000368:Aged; D000069281:Autoimmune Hypophysitis / Q000150:complications*; D018450:Disease Progression; D006801:Humans; D007018:Hypopituitarism / Q000209:etiology*; D008297:Male