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Acta Neurologica Belgica

, Volume 119, Issue 3, pp 337–342 | Cite as

Infundibuloneurohypophysitis associated with autoimmune thrombocytopenia and chiasmal syndrome: a case report

  • Alessandro CaporlinguaEmail author
  • Luca D’Angelo
  • Maria Pia Tropeano
  • Vigliotta Massimo
  • Ludovica De Vincentiis
  • Lucilla Gargano
  • Miriam Cellini
  • Valeria Mercuri
  • Felice Giangaspero
  • Patrizia Gargiulo
  • Antonio Santoro
Original Article
  • 62 Downloads

Abstract

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.

Keywords

Hypophysitis Pituitary Chiasmal syndrome Transsphenoidal surgery 

Notes

Acknowledgements

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.

Compliance with ethical standards

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.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Informed consent

Informed consent was obtained from the patient involved in this study.

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Copyright information

© Belgian Neurological Society 2018

Authors and Affiliations

  • Alessandro Caporlingua
    • 1
    Email author
  • Luca D’Angelo
    • 1
  • Maria Pia Tropeano
    • 1
  • Vigliotta Massimo
    • 1
  • Ludovica De Vincentiis
    • 2
  • Lucilla Gargano
    • 3
  • Miriam Cellini
    • 3
  • Valeria Mercuri
    • 4
  • Felice Giangaspero
    • 2
    • 5
  • Patrizia Gargiulo
    • 4
  • Antonio Santoro
    • 1
  1. 1.Department of Neurology and Psychiatry, Neurosurgery‘Sapienza’ University of RomeRomeItaly
  2. 2.Department of Radiological, Oncological and Pathological Science‘Sapienza’ University of RomeRomeItaly
  3. 3.Endocrinology Unit, Department of Medico-Surgical Sciences and Biotechnologies‘Sapienza’ UniversityLatinaItaly
  4. 4.Endocrinology Unit, Department of Experimental Medicine‘Sapienza’ University of RomeRomeItaly
  5. 5.Neuromed Institute, IRCCSIserniaItaly

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