Lymphocytic Hypophysitis. Report of 3 New Cases and Review of the Literature

Lymphocytic Hypophysitis, Pustulosis Palmaris et Plantaris and Eosinophilia.

“…MRIscanning is known to be most useful for detecting an intrasellar mass caused by lymphocytic hypophysitis (2). In the present case, MRIalso revealed an expanded pituitary mass with the disappearance of high signal intensity of the posterior lobe on T{-weighted images, which is a diagnostic finding frequently observed in diabetes insipidus ( 1 8).…”

“…In class II alleles transcripts of which are knownto present processed antigens to CD4-positive T lymphocytes (9), DR4 and DRw53 loci were shared by 3 patients, respectively. Lymphocytichypophysitis is knownto cause a characteristic progressive hormone loss; the levels of GHand FSH/LHare reduced first, followed by levels of TSHand ACTH,and lastly PRL (2). Thus, about half of the cases presenting panhypopituitarism have been reported to be complicated with hyperprolactinemia (2) as observed in the present patient.…”

“…This disease is known to occur predominantly in females , and the majority of the patients have been diagnosed either during pregnancy or within 14 months after childbirth (2). Somepatients mayshowsymptoms caused by an expanding pituitary mass and may require surgical decompression, and others may be identified by symptoms of hypopituitarism without any radiological abnormalities of the pituitary (3).…”

“…Somepatients mayshowsymptoms caused by an expanding pituitary mass and may require surgical decompression, and others may be identified by symptoms of hypopituitarism without any radiological abnormalities of the pituitary (3). Pathologically, infiltration ofmononuclear cells at the pituitary is usually restricted to adenohypophysis, so that the occurrence of diabetes insipidus due to the involvement of the posterior pituitary is very rare (2,4). Wedescribe here a unique patient with symptomsof an expanding pituitary mass along with diabetes insipidus, both of which became manifest 16 years after her last childbirth.…”

Four Patients with Polyendocrinopathy with Associated Pituitary Hormone Deficiency.

“…Lymphocytic infiltration of the anterior hypophysitis was first correlated with hormone deficiencies in 1962 by Goudie and Pinkerton [31. It has been suggested that some autoimmune disorders are at least partly involved in isolated ACTH deficiency and pregnancy-related hypophysitis [4][5][6]. PGA syndromes associated with isolated pituitary hormone (ACTH, GH or gonadotropin) secretion failure have been reported [7][8][9].…”