2015•MAMC Journal of Medical SciencesOpen access

Lymphocytic infundibuloneurohypophysitis: A rare case report

Manish Gutch, Sukriti Kumar, SyedRazi Mohd, KeshavGupta Kumar, Abhinav Kumar Gupta

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Abstract

Lymphocytic hypophysitis is a neuroendocrine disorder characterized by autoimmune infiammation of the pituitary gland with various degrees of pituitary dysfunction. Coexistence of other autoimmune conditions is reported in the vast majority of cases. The clinical presentation varies depending on the pituitary segment that is more severely affected. Early destruction of the ACTH producing cells is a characteristic feature of lymphocytic adenohypophysitis. Other anterior pituitary hormones can also be affected, but posterior pituitary involvement is absent or minimum. Lymphocytic infundibuloneurohypophysitis (LINH) typically presents as acute onset diabetes insipidus (DI) with intracranial mass effect symptoms. A combination of extensive anterior pituitary involvement and DI characterizes lymphocytic infudibulopanhypophysitis. We are presenting a case report of 35-year-old female presenting with insidious onset DI along with a severe headache and found to have LINH, without the involvement of anterior pituitary hormone secretions.

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Lymphocytic hypophysitis is a neuroendocrine disorder characterized by autoimmune infiammation of the pituitary gland with various degrees of pituitary dysfunction. Coexistence of other autoimmune conditions is reported in the vast majority of cases. The clinical presentation varies depending on the pituitary segment that is more severely affected. Early destruction of the ACTH producing cells is a characteristic feature of lymphocytic adenohypophysitis. Other anterior pituitary hormones can also be affected, but posterior pituitary involvement is absent or minimum. Lymphocytic infundibuloneurohypophysitis (LINH) typically presents as acute onset diabetes insipidus (DI) with intracranial mass effect symptoms. A combination of extensive anterior pituitary involvement and DI characterizes lymphocytic infudibulopanhypophysitis. We are presenting a case report of 35-year-old female presenting with insidious onset DI along with a severe headache and found to have LINH, without the involvement of anterior pituitary hormone secretions.

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Available abstract

Lymphocytic hypophysitis is a neuroendocrine disorder characterized by autoimmune infiammation of the pituitary gland with various degrees of pituitary dysfunction. Coexistence of other autoimmune conditions is reported in the vast majority of cases. The clinical presentation varies depending on the pituitary segment that is more severely affected. Early destruction of the ACTH producing cells is a characteristic feature of lymphocytic adenohypophysitis. Other anterior pituitary hormones can also be affected, but posterior pituitary involvement is absent or minimum. Lymphocytic infundibuloneurohypophysitis (LINH) typically presents as acute onset diabetes insipidus (DI) with intracranial mass effect symptoms. A combination of extensive anterior pituitary involvement and DI characterizes lymphocytic infudibulopanhypophysitis. We are presenting a case report of 35-year-old female presenting with insidious onset DI along with a severe headache and found to have LINH, without the involvement of anterior pituitary hormone secretions.

Key concepts: Medicine, Hypophysitis, Diabetes insipidus, Anterior pituitary, Posterior pituitary, Presentation (obstetrics), Pituitary gland, Hypopituitarism

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