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Autoimmune Hypophysitis with Late Renal Involvement: A Case Report

Authors :
Stefano Iuliano
Maria Carmela Zagari
Margherita Vergine
Alessandro Comi
Michele Andreucci
Gemma Patella
Stefania Giuliano
Sandro La Vignera
Antonio Brunetti
Antonio Aversa
Emanuela A. Greco
Source :
Endocrines, Vol 2, Iss 2, Pp 160-166 (2021)
Publication Year :
2021
Publisher :
MDPI AG, 2021.

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.

Details

Language :
English
ISSN :
2673396X
Volume :
2
Issue :
2
Database :
Directory of Open Access Journals
Journal :
Endocrines
Publication Type :
Academic Journal
Accession number :
edsdoj.922d6be869948468608d2f1942fd03f
Document Type :
article
Full Text :
https://doi.org/10.3390/endocrines2020016