Endocrine Abstracts

Introduction: Hypophysitis is a rare condition corresponding to a chronic inflammation of the pituitary gland, The clinical and radiological signs are not specific and the pathogenesis remains poorly elucidated. The aim of our work is to report the clinico-radiological aspects of hypophysitis.

Material and Methods: This is a retrospective descriptive study of 09 patients hospitalized in the department of Endocrinology-Diabetology-Nutrition of Mohammed-VI University Hospital Center, Oujda, over a period of 5 years who were diagnosed with hypophysitis. All our patients underwent hypothalamic-pituitary MRI. Data were collected from medical records and analyzed by SPSS-V21 software.

Results: The age of our patients ranged from 16 to 49 years, 6 were female. One patient was in immediate postpartum, 3 other patients were already being followed for autoimmune diseases : a Hashimoto disease, a coeliac disease and a lupus. A COVID-19 infection was found in one patient. Polyuro-polydypsia syndrome was the main revealing sign, associated in one case to clinical signs secondary to mass effect and in another case to signs of hypopituitarism. MRI showed a diffuse enlargement of the pituitary gland in 5 cases, a thickened pituitary stalk in 2 cases, markedly homogeneous contrast enhancement of the pituitary gland in 2 cases. Loss of posterior pituitary bright spot was observed in 3 patients. A lymphocytic autoimmune origin was retained in 6 patients. Infiltration of the gland by a tuberculous granuloma was retained in a single case with a good clinical evolution under treatment.

Discussion-conclusion: Hypophysitis is a rare pathology of the pituitary gland that predominates in young women. It is often manifested by hypopituitarism or visual disorders simulating a pituitary adenoma. MRI allows the diagnosis to be suspected by showing an intra- and extra-sellar mass, symmetrical, taking the contrast in a homogeneous way, which is associated during infundibulo-neurohypophysitis to a thickening of the pituitary stem as well as the loss of the spontaneous bright-spot reflecting the absence of vasopressin storage at this level. Its interest is primordial in the diagnosis and the control of the evolution of lymphocytic and granulomatous hypophysitis.