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Korean J Med > Volume 88(5); 2015 > Article
내분비-대사
The Korean Journal of Medicine 2015;88(5): 581-586.
범뇌하수체저하증, 요붕증을 보인 원발성 육아종성 뇌하수체염 1예
오현진, 목지영, 김지은, 조성배, 장상아, 김지현, 이정민
가톨릭대학교 의과대학 내과학교실
Primary Granulomatous Hypophysitis Presenting with Panhypopituitarism and Central Diabetes Insipidus
Hyun Jin Oh, Ji Young Mok, Ji Eun Kim, Sung Bae Cho, Sang Ah Chang, Ji Hyun Kim, Jung Min Lee
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
Corresponding Author: Jung Min Lee ,Tel: +82-2-958-2318, Fax: +82-2-968-7250, Email: leejm68@catholic.ac.kr
Received: May 13, 2014;   Revised: July 28, 2014;   Accepted: August 26, 2014.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Primary granulomatous hypophysitis is a rare inflammatory disorder of the pituitary gland and patients commonly present with symptoms of sellar compression and hypopituitarism. A 48-year-old woman was admitted due to headache and fatigue. Magnetic resonance imaging showed a 21 × 18 × 13-mm round sellar mass with a thickened pituitary stalk. The endocrinological examination revealed panhypopituitarism and diabetes insipidus. Suspecting hypophysitis, the patient was given steroid and hormone replacement therapy. Six months later, she continued to complain of severe headaches and nausea. Computed tomography showed no significant change in the sellar mass. Subsequently, transsphenoidal surgery was performed. The pathological examination revealed granulomatous changes with multinucleated giant cells and primary granulomatous hypophysitis was diagnosed. Her headache resolved, but the pituitary functions did not improve. This is the first reported case in Korea of primary granulomatous hypophysitis with dysfunction of anterior and posterior pituitary gland, including the stalk, without optic chiasm compression.
Keywords: Primary granulomatous hypophysitis; Panhypopituitarism; Diabetes insipidus; Transsphenoidal surgery
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