Endocrine Abstracts

Primary lymphocytic hypophysitis is an autoimmune endocrinopathy affecting mainly women during pregnancy and psot-partum. We report the observation of a 28 year old patient, G5P2C2 with a progressive pregnancy at 32 SA, with a history of hypertension without any particular familial history. The patient had an ophthalmologic examination as part of the exploration of the repercussions of hypertension, which objectified an abnormal excavation of the left eye at the fundus examination supplemented by a visual field that found complete narrowing of the left eye and temporal hemianopsia of the right eye. A pituitary MRI without injection found an intra-selar mass with supra-selar extension evoking a pituitary adenoma. Clinical examination was without particularity, apart from headaches, On the hormonal level, a slight hyperprolactinemia of about 179 ng/ml was found. In this context, the diagnosis of pituitary disease is highly likely, and the patient was put on corticosteroid therapy at a dose of 3 bolus of 120 mg of methylprednisone with a relay of prednisone at a dose of 40 mg/day. After 3 days of CTC, the control visual field returned to normal, with a disappearance of a few drops of methylprednisone. Four months postpartum, magnetic resonance imaging showed complete resolution of the pituitary mass. In total: the diagnosis of Primary lymphocytic hypophysitis must be made in an evocative context such as pregnancy and postpartum, as early as possible, to avoid an unnecessary aggressive treatment and the evolution of the pathology with a risk of hormonal repercussions, essentially corticotropic.