Lymphocytic hypophysitis in the elderly

A case presentation and review of the literature

Teresa Brown, Sudeep Dhillon, Betty Chung, Eric Richfield, Sara Lubitz

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Lymphocytic hypophysitis (LH), an autoimmune mediated chronic inflammation of the pituitary gland, is uncommon in the elderly population greater than 70 years old. It most commonly occurs in peripartum women and classically presents with mass-effect symptoms, hyperprolactinemia, or with symptoms of adenohypophysial or neurohypophysial involvement. We report a case of an elderly female who presented with headaches, visual defects, panhypopituitarism, and a sellar mass thought to be a non-functioning pituitary macroadenoma. On surgical pathology the diagnosis of LH was made. In a comprehensive literature search, we have found only sixteen cases of LH in the elderly. A comparison of the clinical differences between the pediatric, adult, and elderly populations with LH revealed notable differences between the clinical presentations and hormonal deficiencies present in the pediatric versus the adult and elderly populations. A much larger portion of adults and the elderly present with headache and visual disturbances, while a majority of the pediatric population presents with diabetes insipidus and growth hormone deficiency. Adults and elderly with LH have a much higher association with autoimmune disease than children. There was no gender predilection found in the elderly population, which is a notable difference from the adult population in which female cases of LH are much more common.

Original languageEnglish (US)
Pages (from-to)43-49
Number of pages7
JournalInterdisciplinary Neurosurgery: Advanced Techniques and Case Management
Volume8
DOIs
StatePublished - Jun 1 2017

Fingerprint

Population
Pediatrics
Headache
Peripartum Period
Surgical Pathology
Diabetes Insipidus
Hyperprolactinemia
Autoimmune Hypophysitis
Pituitary Gland
Growth Hormone
Autoimmune Diseases
Inflammation
Combined Pituitary Hormone Deficiency

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Surgery

Cite this

@article{eee76ac9b4604df3bfe6f982b269fc5e,
title = "Lymphocytic hypophysitis in the elderly: A case presentation and review of the literature",
abstract = "Lymphocytic hypophysitis (LH), an autoimmune mediated chronic inflammation of the pituitary gland, is uncommon in the elderly population greater than 70 years old. It most commonly occurs in peripartum women and classically presents with mass-effect symptoms, hyperprolactinemia, or with symptoms of adenohypophysial or neurohypophysial involvement. We report a case of an elderly female who presented with headaches, visual defects, panhypopituitarism, and a sellar mass thought to be a non-functioning pituitary macroadenoma. On surgical pathology the diagnosis of LH was made. In a comprehensive literature search, we have found only sixteen cases of LH in the elderly. A comparison of the clinical differences between the pediatric, adult, and elderly populations with LH revealed notable differences between the clinical presentations and hormonal deficiencies present in the pediatric versus the adult and elderly populations. A much larger portion of adults and the elderly present with headache and visual disturbances, while a majority of the pediatric population presents with diabetes insipidus and growth hormone deficiency. Adults and elderly with LH have a much higher association with autoimmune disease than children. There was no gender predilection found in the elderly population, which is a notable difference from the adult population in which female cases of LH are much more common.",
author = "Teresa Brown and Sudeep Dhillon and Betty Chung and Eric Richfield and Sara Lubitz",
year = "2017",
month = "6",
day = "1",
doi = "https://doi.org/10.1016/j.inat.2016.10.007",
language = "English (US)",
volume = "8",
pages = "43--49",
journal = "Interdisciplinary Neurosurgery: Advanced Techniques and Case Management",
issn = "2214-7519",
publisher = "Elsevier BV",

}

Lymphocytic hypophysitis in the elderly : A case presentation and review of the literature. / Brown, Teresa; Dhillon, Sudeep; Chung, Betty; Richfield, Eric; Lubitz, Sara.

In: Interdisciplinary Neurosurgery: Advanced Techniques and Case Management, Vol. 8, 01.06.2017, p. 43-49.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Lymphocytic hypophysitis in the elderly

T2 - A case presentation and review of the literature

AU - Brown, Teresa

AU - Dhillon, Sudeep

AU - Chung, Betty

AU - Richfield, Eric

AU - Lubitz, Sara

PY - 2017/6/1

Y1 - 2017/6/1

N2 - Lymphocytic hypophysitis (LH), an autoimmune mediated chronic inflammation of the pituitary gland, is uncommon in the elderly population greater than 70 years old. It most commonly occurs in peripartum women and classically presents with mass-effect symptoms, hyperprolactinemia, or with symptoms of adenohypophysial or neurohypophysial involvement. We report a case of an elderly female who presented with headaches, visual defects, panhypopituitarism, and a sellar mass thought to be a non-functioning pituitary macroadenoma. On surgical pathology the diagnosis of LH was made. In a comprehensive literature search, we have found only sixteen cases of LH in the elderly. A comparison of the clinical differences between the pediatric, adult, and elderly populations with LH revealed notable differences between the clinical presentations and hormonal deficiencies present in the pediatric versus the adult and elderly populations. A much larger portion of adults and the elderly present with headache and visual disturbances, while a majority of the pediatric population presents with diabetes insipidus and growth hormone deficiency. Adults and elderly with LH have a much higher association with autoimmune disease than children. There was no gender predilection found in the elderly population, which is a notable difference from the adult population in which female cases of LH are much more common.

AB - Lymphocytic hypophysitis (LH), an autoimmune mediated chronic inflammation of the pituitary gland, is uncommon in the elderly population greater than 70 years old. It most commonly occurs in peripartum women and classically presents with mass-effect symptoms, hyperprolactinemia, or with symptoms of adenohypophysial or neurohypophysial involvement. We report a case of an elderly female who presented with headaches, visual defects, panhypopituitarism, and a sellar mass thought to be a non-functioning pituitary macroadenoma. On surgical pathology the diagnosis of LH was made. In a comprehensive literature search, we have found only sixteen cases of LH in the elderly. A comparison of the clinical differences between the pediatric, adult, and elderly populations with LH revealed notable differences between the clinical presentations and hormonal deficiencies present in the pediatric versus the adult and elderly populations. A much larger portion of adults and the elderly present with headache and visual disturbances, while a majority of the pediatric population presents with diabetes insipidus and growth hormone deficiency. Adults and elderly with LH have a much higher association with autoimmune disease than children. There was no gender predilection found in the elderly population, which is a notable difference from the adult population in which female cases of LH are much more common.

UR - http://www.scopus.com/inward/record.url?scp=85011661608&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85011661608&partnerID=8YFLogxK

U2 - https://doi.org/10.1016/j.inat.2016.10.007

DO - https://doi.org/10.1016/j.inat.2016.10.007

M3 - Article

VL - 8

SP - 43

EP - 49

JO - Interdisciplinary Neurosurgery: Advanced Techniques and Case Management

JF - Interdisciplinary Neurosurgery: Advanced Techniques and Case Management

SN - 2214-7519

ER -