Endocrine Abstracts

Background and aim: Lymphocytic hypophysitis is heterogeneous inflammatory processes of the pituitary gland and may cause isolated hormone deficiency, but rarely occurs as panhypopituitarism. We aim to present a rare case of ulcerative colitis coexisting with lymphocytic hypophysitis.

Case report: A 42-years old woman with ulcerative colitis was applied for our department of internal medicine with hypoglycemia. Her capillary blood glucose levels were found 22 and 33 mg/dl without typical hypoglycemic symptoms. She complained from weakness, anorexia, weight loss, secondary amenorrhea and chronic diarrhea for three months. She was diagnosed with ulcerative colitis 11 years ago and was treated with meselazine tablets and enema. Oral steroid therapy was started in 2014 and doses were gradually tapered and stopped. Her physical examination revealed pulse rate of 55 per minute, blood pressure of 90/60 mm Hg with pale skin. No other abnormal finding was found on physical examination. Secondary hypothyroidism and secondary adrenal insufficiency were considered according to endocrinological examinations. Prolonged 75 g oral glucose tolerance test was also performed, hypoglycaemia was not observed during the test. Pituitary magnetic resonance imaging showed findings consistent with lymphocytic hypophysitis. Present laboratory and imaging findings suggested the presence of lymphocytic hypophysitis. She was initially treated with hydrocortisone and then L-thyroxine replacement therapy. After the treatment, we observed markedly improvement her signs and symptoms such as weakness, anorexia and hypoglycemia.

Conclusions: Although some autoimmune diseases may be together, coexistence of ulcerative colitis and lymphocytic hypophysitis is rarely situation. These patients should be followed in terms of autoimmune polyglandular syndrome.