Endocrine Abstracts

Introduction: Lymphocytic hypophysitis is a rare inflammatory disease of the pituitary gland of autoimmune origin, related to a diffuse infiltration of the pituitary gland sometimes leading to severe hypopituitarism. It is frequent in pregnant or postpartum women.

Case report: A 28 year old female patient, followed up for pituitary microadenoma with prolactin for 5 years under dostinex 1 tablet/week who reported headaches with visual acuity decrease with signs of corticotropic and gonadotropic insufficiency, pituitary MRI showed an intrasellar process of 3.6*2.5 mm, at FO : AV at 10/10 in ODG with diplopia, the CV was discreetly altered and the hormonal assessment objectified a corticotropic, and gonadotropic deficit. In the meantime, the patient presented for 1 year a polyuropolydipsic syndrome, the diagnosis of an osmotic polyuria following a hypercalcemia in the framework of a multiple endocrine neoplasia type 1 with pituitary adenoma was evoked but the calcemia was normal, the urinary osmolarity was low at 200 making evoke a polyuria insipidus a test of hydric restriction is planned. In view of this polyuropolydipsic syndrome of insipid appearance and the tumor syndrome which is not explained by the microadenoma, a lymphocytic hypophysitis was evoked and the workup was completed by antinuclear and anti-DNA antibodies.

Discussion: Lymphocytic hypophysitis is a rare autoimmune disorder predominantly affecting young women and is most often manifested by headache, visual disturbances or hypopituitarism. This observation shows the interest to think about it in front of a pituitary adenoma picture especially when it is a microadenoma not explaining the tumor syndrome and the polyuropolydipsic syndrome.