Infundibuloneurohypophysitis associated with autoimmune thrombocytopenia and chiasmal syndrome: a case report
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Lymphocytic hypophysitis is an uncommon autoimmune disease. It may involve the adenohypophysis, neurohypophysis and pituitary stalk. It is most often encountered in pregnant women. Its diagnosis and management pose a significant challenge, as its clinical manifestation and appearance in imaging studies are difficult to distinguish from more common lesion of the sellar region (e.g., pituitary adenomas). We present the case of a 42-year-old man who presented with a chiasmatic syndrome, diabetes insipidus and hypopituitarism. Brain MRI documented a sellar lesion with suprasellar extension and optic chiasm dislocation. He underwent an endoscopic endonasal transsphenoidal resection of the mass. Histopathological examination revealed a lymphocytic hypophysitis. Visual symptoms improved dramatically postoperatively with permanent diabetes insipidus and panhypopituitarism. We discuss the indication for surgical resection in patients with inflammatory lesions extending to the suprasellar region associated with visual impairment.
KeywordsHypophysitis Pituitary Chiasmal syndrome Transsphenoidal surgery
Alessandro Caporlingua M.D. and Luca D’Angelo M.D., Ph.D. contributed equally to the draft of the manuscript. Thus, they have to be considered as first co-authors.
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Conflict of interest
The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
This article does not contain any studies with human participants performed by any of the authors.
Informed consent was obtained from the patient involved in this study.
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