Abstract
We report on a man with a progressively increasing pituitary mass, as demonstrated by MRI. It produced neurological and ophthalmological symptoms, and, ultimately, hypopituitarism. MRI also showed enlargement of the pituitary stalk and a dural tail phenomenon. An increased titer of antipituitary antibodies (1:16) was detected in the serum. Pituitary biopsy showed autoimmune hypophysitis (AH). Neither methylprednisolone pulse therapy nor a subsequent treatment with azathioprine were successful in recovering pituitary function, or in inducing a significant reduction of the pituitary mass after an initial, transient clinical and neuroradiological improvement. Anterior pituitary function evaluation revealed persistent hypopituitarism. AH is a relatively rare condition, particularly in males, but it represents an emerging entity in the diagnostic management of pituitary masses. This case shows that response to appropriate therapy for hypophysitis may not be very favorable and confirms that diagnostic management of nonsecreting pituitary masses can be a challenge. Clinical, imaging, and laboratory findings are useful for suggesting the diagnosis, but pituitary biopsy may be necessary to confirm it.
| Original language | English |
|---|---|
| Pages (from-to) | 126-134 |
| Number of pages | 9 |
| Journal | TheScientificWorldJournal |
| Volume | 10 |
| DOIs | |
| Publication status | Published - Jan 21 2010 |
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Keywords
- Antipituitary antibodies
- Autoimmune hypophysitis
- Fibrosis
- Magnetic resonance imaging
- Pituitary mass
ASJC Scopus subject areas
- Biochemistry, Genetics and Molecular Biology(all)
- Environmental Science(all)
- Medicine(all)
Cite this
Lymphocytic hypophysitis : Differential diagnosis and effects of high-dose pulse steroids, followed by azathioprine, on the pituitary mass and endocrine abnormalities - Report of a case and literature review. / Curtò, Lorenzo; Torre, Maria L.; Cotta, Oana R.; Losa, Marco; Terreni, Maria R.; Santarpia, Libero; Trimarchi, Francesco; Cannavò, Salvatore.
In: TheScientificWorldJournal, Vol. 10, 21.01.2010, p. 126-134.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Lymphocytic hypophysitis
T2 - Differential diagnosis and effects of high-dose pulse steroids, followed by azathioprine, on the pituitary mass and endocrine abnormalities - Report of a case and literature review
AU - Curtò, Lorenzo
AU - Torre, Maria L.
AU - Cotta, Oana R.
AU - Losa, Marco
AU - Terreni, Maria R.
AU - Santarpia, Libero
AU - Trimarchi, Francesco
AU - Cannavò, Salvatore
PY - 2010/1/21
Y1 - 2010/1/21
N2 - We report on a man with a progressively increasing pituitary mass, as demonstrated by MRI. It produced neurological and ophthalmological symptoms, and, ultimately, hypopituitarism. MRI also showed enlargement of the pituitary stalk and a dural tail phenomenon. An increased titer of antipituitary antibodies (1:16) was detected in the serum. Pituitary biopsy showed autoimmune hypophysitis (AH). Neither methylprednisolone pulse therapy nor a subsequent treatment with azathioprine were successful in recovering pituitary function, or in inducing a significant reduction of the pituitary mass after an initial, transient clinical and neuroradiological improvement. Anterior pituitary function evaluation revealed persistent hypopituitarism. AH is a relatively rare condition, particularly in males, but it represents an emerging entity in the diagnostic management of pituitary masses. This case shows that response to appropriate therapy for hypophysitis may not be very favorable and confirms that diagnostic management of nonsecreting pituitary masses can be a challenge. Clinical, imaging, and laboratory findings are useful for suggesting the diagnosis, but pituitary biopsy may be necessary to confirm it.
AB - We report on a man with a progressively increasing pituitary mass, as demonstrated by MRI. It produced neurological and ophthalmological symptoms, and, ultimately, hypopituitarism. MRI also showed enlargement of the pituitary stalk and a dural tail phenomenon. An increased titer of antipituitary antibodies (1:16) was detected in the serum. Pituitary biopsy showed autoimmune hypophysitis (AH). Neither methylprednisolone pulse therapy nor a subsequent treatment with azathioprine were successful in recovering pituitary function, or in inducing a significant reduction of the pituitary mass after an initial, transient clinical and neuroradiological improvement. Anterior pituitary function evaluation revealed persistent hypopituitarism. AH is a relatively rare condition, particularly in males, but it represents an emerging entity in the diagnostic management of pituitary masses. This case shows that response to appropriate therapy for hypophysitis may not be very favorable and confirms that diagnostic management of nonsecreting pituitary masses can be a challenge. Clinical, imaging, and laboratory findings are useful for suggesting the diagnosis, but pituitary biopsy may be necessary to confirm it.
KW - Antipituitary antibodies
KW - Autoimmune hypophysitis
KW - Fibrosis
KW - Magnetic resonance imaging
KW - Pituitary mass
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U2 - 10.1100/tsw.2010.24
DO - 10.1100/tsw.2010.24
M3 - Article
VL - 10
SP - 126
EP - 134
JO - The Scientific World Journal
JF - The Scientific World Journal
SN - 2356-6140
ER -