Lymphocytic hypophysitis (lymphocytic adenohypophysitis, lymphocytic infundibulohypophysitis) is an autoimmune disorder with a lymphoid infiltrate of the pituitary with or without suprasellar extension.
The vast majority (> 90%) of cases involve women.
Presentations:
(1) acute onset during late pregnancy or the early postpartum state with headache and visual defects
(2) insidious onset of hypopituitarism
(3) component of an autoimmune polyendocrinopathy
(4) postpartum amenorrhea
Laboratory findings:
(1) diabetes insipidus
(2) hypopituitarism with decreases in ACTH and/or TSH
(3) autoantibodies to vasopressin, thyroid antigens or other endocrine antigens
(4) variable antinuclear antibodies
Imaging findings on CT or MRI are nonspecific with pituitary mass or enlargement with variable thickening of the pituitary stalk and suprasellar extension.
Histologic examination of pituitary tissue shows a lymphoplasmacytic infiltration with lymphoid follicles and fibrosis.
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