1. Autoimmune Hypophysitis with Late Renal Involvement: A Case Report
- Author
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Stefania Giuliano, Antonio Aversa, Sandro La Vignera, Maria Carmela Zagari, Antonio Brunetti, Gemma Patella, Stefano Iuliano, Alessandro Comi, Emanuela Greco, Michele Andreucci, and Margherita Vergine
- Subjects
medicine.medical_specialty ,Pituitary gland ,030209 endocrinology & metabolism ,autoimmune disease ,Hypopituitarism ,Gastroenterology ,Diseases of the endocrine glands. Clinical endocrinology ,03 medical and health sciences ,0302 clinical medicine ,systemic lupus erythematosus ,Internal medicine ,Membranoproliferative glomerulonephritis ,medicine ,Hormone replacement therapy ,Autoimmune disease ,business.industry ,Pituitary tumors ,medicine.disease ,RC648-665 ,autoimmune hypophysitis ,medicine.anatomical_structure ,hypopituitarism ,sexual dysfunction ,030220 oncology & carcinogenesis ,Autoimmune hypophysitis ,Headaches ,medicine.symptom ,business - Abstract
We report a case of a 50-year-old male admitted to the Endocrinology Unit because of persistent headaches, nausea, feeling tired, sudden weight loss, cold intolerance, decreased appetite, and lack of sex interest. Diagnostic workup showed a 6-millimeter pituitary tumor without signs of compression, and a condition of progressive panhypopituitarism. After 12 months of hormone replacement therapy, the patient was hospitalized because of sudden weight gain, periorbital-peripheral edema, severe dyslipidemia, hypertension, and proteinuria. Corticosteroid therapy was shifted from oral to continuous intravenous infusion, and once the diagnosis of “immune complex-mediated glomerulonephritis with mesangial deposits suggestive for membranoproliferative glomerulonephritis type IIIIgG4-positive” was made, the immunosuppressant mycophenolate (1500 mg/day) was started. After a 6-month follow-up, the complete resolution of renal symptoms was accompanied by the disappearance of a pituitary lesion and the patient was back to prior hormone replacement therapy. Autoimmune hypophysitis (AH) is a rare autoimmune inflammatory disease of the pituitary gland that can impair hormone secretion and function. IgG4-hypophysitis is rare and is usually associated with other IgG4-related diseases. Herein, we describe a rare case of AH associated with late renal disease, and without any other organ involvement.
- Published
- 2021