Endocrine Abstracts

Introduction: Lymphocytic hypophysitis is a rare inflammatory disorder of the pituitary gland with autoimmune origin, related to a diffuse infiltration of the pituitary gland, sometimes resulting in severe hypopituitarism. It is common in young women in late pregnancy or postpartum, however, its occurrence in men is rare with only a few cases reported in the literature. We report the case of a lymphocytic hypophysitis in a young male patient who presented for a pituitary macroadenoma.

Observation: A 31- year-old male patient, having a sister followed for lichen, presented, 10 days before admission, brutal headache, strabismus of the left eye, ptosis and a slight decrease in visual acuity with clinical signs of corticotropic and gonadotropic deficiency, pituitary MRI showed an intrasellar process of 17 * 20 mm with deformation of the sellar floor, repression of the stem and the chiasma with partial filling of the optochiasmatic cistern. The hormonal assessment showed corticotropic, thyrotropic and gonadotropic deficiency. The patient was put in substitution and sent to neurosurgery for adenomectomy, meanwhile the patient presented a spontaneous resolution of headaches and visual disturbances, the MRI control showed a regression in size of the pituitary adenoma of 9 * 10 mm, with persistence of hormonal deficits. Autoimmune exploration have shown positive anti-nuclear and anti-DNA antibodies and the patient was sent to internal medicine department where he was put on steroids.

Conclusion:: Lymphocytic hypophysitis is a rare autoimmune disorder, predominant in young women most often manifested by headache, visual disturbances or hypopituitarism. This observation shows the interest of thinking about it in front of a context of pituitary adenoma even in a male patient.