RECURRENT LYMPHOCYTIC HYPOPHYSITIS - CASE-REPORT

OBJECTIVE AND IMPORTANCE: Lymphocytic hypophysitis is being recognized with increasing frequency, but the long-term course is not well known . Recurrence of lymphocytic hypophysitis after a long interval has nev er been reported. CLINICAL PRESENTATION: A 53-year-old woman presented with central diabetes insipidus, Magnetic resonance imaging (MRI) rev ealed an intrasellar lesion. Transsphenoidal biopsy yielded a diagnosi s of lymphocytic hypophysitis. Regression of the lesion was confirmed by follow-up MRI, The patient lived normally, with gradual improvement of diabetes insipidus, until she suddenly became aware of a visual de fect, which developed into bitemporal hemianopsia 2 years after the bi opsy, MRI revealed a large sellar lesion extending to the hypothalamus . However, the adenohypophysial function remained normal and the mild diabetes insipidus continued unchanged. INTERVENTION: Prompt corticost eroid treatment was remarkably effective. The visual defect disappeare d during steroid therapy, and a significant reduction of the lesion wa s revealed by MRI. CONCLUSION: It is suggested that long-term follow-u p with endocrinological icai and radiological studies may be necessary in cases of lymphocytic hypophysitis, Recurrent cases should be promp tly treated with steroids when a definitive histological diagnosis had been confirmed.