Clinical course of a pituitary macroadenoma in the first trimester of pregnancy: Probable lymphocytic hypophysitis

Recent findings revealed that the clinical features of lymphocytic hypophys itis are more complicated than previously thought. It is rarely described i n the first trimester of pregnancy and signs of meningeal irritation are in frequently reported. In this study, a pregnant woman in her first trimester of pregnancy with clinical and radiological characteristics of a pituitary macroadenoma is described. The patient's pituitary profile revealed a rela tively low prolactin for her stage of pregnancy. Unusual findings were neck stiffness associated with headache, nausea and vomiting. She was treated c onservatively. Spontaneous complete resolution of the pituitary mass in the postpartum period led us to conclude that the correct diagnosis should be hypophysitis. Hypophysitis should be considered in the differential diagnos is of a pituitary mass presenting in early stages of pregnancy with symptom s mimicking hyperemesis gravidarum and/or meningeal irritation.