Lymphocytic hypophysitis: non-invasive diagnosis and treatment by high dose methylprednisolone pulse therapy?

Criteria for the non-invasive diagnosis of lymphocytic hypophysitis (LyHy) and the results of the first prospective trial of high dose methylprednisol one pulse therapy (HDMPT) in nine patients are presented. In three patients , the diagnosis was established histologically, and in the others by clinic al and endocrinological assessment, MRI, CSF examination, and measurement o f thyroglobulin autoantibody concentration. After HDMPT, adenopituitary fun ction improved in four of the nine patients and diabetes insipidus ceased o r improved in all four concerned patients. The MRI findings improved in sev en patients. LyHy has to be considered in the differential diagnosis of sel lar lesions. The presumptive non-invasive diagnosis of LyHy seems possible in a high proportion of patients. HDMPT may result in the improvement of cl inical, endocrinological, and MRI findings.