J Korean Ophthalmol Soc.  2006 Jul;47(7):1183-1188.

A Case of Lymphocytic Hypophysitis during Pregnancy

• Kim SW
• Kwon JD
• Park DH

Abstract

PURPOSE: To report a rare case of lymphocytic hypophysitis in a 31-year-old woman who presented with gradually progressive bilateral visual loss during the third trimester of pregnancy.
METHODS
Ophthalmologic examination revealed best corrected visual acuity of 0.02 OD and counting fingers at 20 cm OS. Pupil examination revealed no relative afferent pupillary defect in either eye and intraocular pressure was normal in both eyes. A visual field test revealed nearly total visual defect sparing superotemporal area OD and total defect OS. An MRI of the head was performed.
RESULTS
At the time of transsphenoidal surgery following the patient's delivery, a frozen biopsy of the lesion revealed diffuse lymphocytic infilteration and fibrosis of the pituitary gland consistent with the diagnosis of lymphocytic hypophysitis. Postoperatively the patient was treated for hypopituitarism. At 5 weeks postoperative, her best corrected visual acuity was 1.0 OU, and visual field defects resolved in both eyes. On follow-up by telephone for postoperative 7 months, the patient remained visually asymptomatic.
CONCLUSIONS
The clinical presentation of lymphocytic hypophysitis may mimic pituitary adenoma, lymphoma, germinoma, and histiocytosis. The diagnosis should be suspected in any pregnant or postpartum patient with an intrasellar or suprasellar mass.

Keyword

Lymphocytic hypophysitis; Pituitary adenoma; Pregnancy

MeSH Terms

Adult
Biopsy
Diagnosis
Female
Fibrosis
Fingers
Follow-Up Studies
Germinoma
Head
Histiocytosis
Humans
Hypopituitarism
Intraocular Pressure
Lymphoma
Magnetic Resonance Imaging
Pituitary Gland
Pituitary Neoplasms
Postpartum Period
Pregnancy Trimester, Third
Pregnancy*
Pupil
Pupil Disorders
Telephone
Visual Acuity
Visual Field Tests
Visual Fields