Kamran Amna, Ghazy Ahmed, Misakyan Narine, Fatima Tehreem, Najeeb Nazish
Internal Medicine, Capital Health Regional Medical Center, Trenton, USA.
Internal Medicine, King Edward Medical University, Mayo Hospital, Lahore, PAK.
Cureus. 2024 Apr 27;16(4):e59167. doi: 10.7759/cureus.59167. eCollection 2024 Apr.
Autoimmune hypophysitis (AH) is an uncommon condition where there is inflammation of the pituitary gland which leads to hormonal imbalances. It is often associated with autoimmune diseases; however, a case is yet to be reported with an association of AH with seronegative rheumatoid arthritis (RA). We present a case of a 45-year-old female who complained of polyuria/polydipsia and rapid weight gain. An MRI of the head revealed enlargement of the pituitary gland, concerning for AH. Although she was initially treated for diabetes insipidus, she began reporting new complaints of joint pains and morning stiffness. She was clinically diagnosed with seronegative RA and improved with a trial of hydroxychloroquine. A repeat MRI showed improvement in the abnormal pituitary findings, and the patient was closely monitored with a multidisciplinary approach. Diagnosing and managing patients with AH are topics that are still being explored and researched as it is a relatively rare pathology. Consequently, we found the need to discuss the relationship of AH with seronegative RA and delve into the various diagnostic and treatment approaches.
自身免疫性垂体炎(AH)是一种罕见的疾病,其特征为垂体发生炎症,进而导致激素失衡。它常与自身免疫性疾病相关;然而,AH与血清阴性类风湿关节炎(RA)相关的病例尚未见报道。我们报告一例45岁女性患者,她主诉多尿/烦渴及体重快速增加。头部MRI显示垂体增大,怀疑为AH。尽管她最初接受了尿崩症的治疗,但她开始报告新的关节疼痛和晨僵症状。她临床诊断为血清阴性RA,试用羟氯喹后病情改善。复查MRI显示垂体异常表现有所改善,患者采用多学科方法进行密切监测。由于AH是一种相对罕见的病理情况,对AH患者的诊断和管理仍是正在探索和研究的课题。因此,我们认为有必要讨论AH与血清阴性RA的关系,并深入探讨各种诊断和治疗方法。