A case of IgG4-related hypophysitis without pituitary insufficiency

J Clin Endocrinol Metab. 2013 May;98(5):1808-11. doi: 10.1210/jc.2013-1088. Epub 2013 Mar 20.

Abstract

Context: IgG4-related hypophysitis is a novel clinical disease entity, which is typically complicated by hypopituitarism.

Objective: The objective of the study was to describe a novel case of IgG4-related hypophysitis without pituitary insufficiency and summarize the current relevant literature.

Patient and methods: A 55-year-old Japanese man presented with an enlarged pituitary gland and bitemporal hemianopsia. Endocrine studies revealed normal pituitary function, although his serum IgG4 level was high. The patient underwent a transsphenoidal biopsy of the pituitary gland, and the pathological tissues were consistent with IgG4-related hypophysitis. Oral prednisolone therapy was started, and after 6 months, his serum IgG4 level decreased and visual field improved.

Conclusion: We described the first case of IgG4-related hypophysitis without pituitary insufficiency. However, further case collection is needed to characterize the pathophysiology of IgG4-related hypophysitis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use
  • Hemianopsia / etiology
  • Hemianopsia / prevention & control
  • Humans
  • Immunoglobulin G / analysis*
  • Male
  • Middle Aged
  • Organ Size / drug effects
  • Pituitary Diseases / drug therapy
  • Pituitary Diseases / immunology*
  • Pituitary Diseases / pathology
  • Pituitary Diseases / physiopathology
  • Pituitary Gland / drug effects
  • Pituitary Gland / immunology*
  • Pituitary Gland / pathology
  • Pituitary Gland / physiopathology
  • Prednisolone / therapeutic use
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents
  • Immunoglobulin G
  • Prednisolone