Tsagarakis Stylianos, Vassiliadi Dimitra, Malagari Katerina, Kontogeorgos George, Thalassinos Nicolaos
Department of Endocrinology, Diabetes and Metabolism Evangelismos Hospital, and 2nd Department of Radiology, University of Athens, Athens, Greece.
Endocrine. 2004 Nov;25(2):85-90. doi: 10.1385/ENDO:25:2:085.
Lymphocytic hypophysitis (LH) is an inflammatory dis-ease of the anterior pituitary. The varying clinical presentation and the short-term outcome of LH have been extensively described in several case reports or small cohort studies. However, little is known about the long-term outcome of this disease. It is currently believed that if left untreated it may run a self-limited course followed by full resolution of the mass with or without persisting pituitary failure. We describe a 29-yr-old female who presented with secondary amenorrhea, headaches, visual defects, and a pituitary mass, which was removed by transsphenoidal surgery. Histology was consistent with the diagnosis of LH. Following surgery the patient demonstrated a gradual recovery of gonadotroph function with restoration of menses and a successful pregnancy. However, 3 yr after delivery and 6 yr following her initial presentation she developed amenorrhea, headaches, and a pituitary mass. Institution of steroid therapy resulted in resolution of the pituitary mass. In summary, this case illustrates that similarly to many other disorders of autoimmune origin LH may run a fluctuating course and late recurrence is possible even after the successful removal of the inflammatory mass, thus necessitating long-term follow-up of these patients.
