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Lymphocytic (Autoimmune) Hypophysitis

Reviewed 06/2019
 


BASICS

DESCRIPTION

  • A rare autoimmune disease that occurs when the pituitary gland is infiltrated with lymphocytes and plasma cells, leading to impaired hormonal secretion

  • Patients present with varying d...

DIAGNOSIS

HISTORY

  • Four categories of symptoms are the following: pituitary enlargement, hypopituitarism, diabetes insipidus, and hyperprolactinemia (1)[C].

  • Initial presentation is most often related to ...

TREATMENT

  • Spontaneous remission can occur (4)[C].

  • With acute presentation, the immediate concern is to treat the underlying hypopituitarism, decrease mass effect to preserve vision, reduce inflammation...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Careful follow-up of hormone levels to determine appropriate hormone replacement, serial visual field testing, and annual imaging are recommende...

REFERENCES

1
Caturegli P, Newschaffer C, Olivi A, et al. Autoimmune hypophysitis. Endocr Rev.  2005;26(5):599–614. [View Abstract on OvidMedline]
2
Singhal S, Singh H, Furlong K, et al. Lymphocytic ...

ADDITIONAL READING

  • Falorni A, Minarelli V, Bartoloni E, et al. Diagnosis and classification of autoimmune hypophysitis. Autoimmun Rev.  2014;13(4–5):412–416. [View Abstract on OvidMedline]

  • Smith C...

CODES

ICD10

E23.0 Hypopituitarism 

ICD9

253.2 Panhypopituitarism 

SNOMED

  • 61701006 Lymphocytic hypopituitarism

  • 237707009 Lymphocytic hypophysitis of pregnancy (disorder)

CLINICAL PEARLS

  • Suspect lymphocytic hypophysitis in patients presenting with headache and visual field impairments during or soon after pregnancy.

  • Lymphocytic hypophysitis is characterized by the prese...

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