Lymphocytic hypophysitis in a man presenting with hypercalcemia

A 59-year-old man with a 30-year history of type 2 diabetes mellitus presen ted with fatigue, confusion, and weight loss over a 3-month period. He was found to be hypercalcemic (11.8 mg/dL) and dehydrated, and his hypercalcemi a improved with intravenous fluids. While in the hospital, he developed hyp onatremia, hypoglycemia, and hypotension. He was found to have a subnormal cortisol level of 2.3 mug/dL at baseline, which increased to only 5.6 mug/d L 60 minutes after a 250-mug corticotropin intravenous stimulation test. Th e patient developed pneumonia and adult respiratory distress syndrome and d ied of an acute myocardial infarction. During the autopsy, he was found to have lymphocytic hypophysitis with a severe reduction in corticotropin-prod ucing anterior pituitary cells. No malignancy was identified at autopsy. He is the first male patient to be described in the literature who presented with hypercalcemia caused by lymphocytic hypophysitis.