A case of apoplectic lymphocytic hypophysitis complicated by polymyalgia rheumatica

Abstract

A case of apoplectic lymphocytic hypophysitis complicated by polymyalgia rheumatica (PMA) is described. A 72-year-old man was admitted to our hospital due to severe headache. Two months prior to admission, the patients had exhibited recent-onset stiffness and myalgia of shoulder and pelvic girdle that was compatible with PMR. Magnetic resonance imaging revealed a mass lesion in the pituitary fossa with focal hemorrhage. Endocrinologic studies demonstrated hypopituitarism. The headache and myalgia were improving with corticosteroid treatment; however, a trans-sphenoidal surgery was performed due to visual field loss. A white-colored mass was resected, and histologic examination showed diffuse infiltration of lymphocytes and plasma cells consistent with lymphocytic hypophysitis. Post-operatively, the headache and visual field loss resolved completely. This is the first documented case of apoplectic lymphocytic hypophysitis complicating PMR, and a possible mechanism for this rare association was discussed.

DOI: 10.1007/s00296-010-1535-x

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Cite this paper

@article{Tanaka2010ACO, title={A case of apoplectic lymphocytic hypophysitis complicated by polymyalgia rheumatica}, author={Yasuko Tanaka and Tomohito Hirao and Keisuke Tsutsumi and Taiichiro Miyashita and Yasumori Izumi and Yumi Mihara and Masahiro Ito and Hiroshi Baba and Kiysohi Migita}, journal={Rheumatology International}, year={2010}, volume={33}, pages={215-218} }