A Case of Lymphocytic Hypophysitis during Pregnancy.

Kim, Sang Woo; Kwon, Jung Do; Park, Do Hoon

Case Report

Journal of the Korean Ophthalmological Society 2006;47(7):1183-1188.
Published online July 31, 2006.

A Case of Lymphocytic Hypophysitis during Pregnancy.

Sang Woo Kim, Jung Do Kwon, Do Hoon Park

Department of Ophthalmology Wallace Memorial Baptist Hospital, Pusan, Korea. oph@wmbh.co.kr

임산부에서 시력저하로 발견된 림프구성 뇌하수체염 1예

김상우,권정도,박도훈

Department of Ophthalmology Wallace Memorial Baptist Hospital, Pusan, Korea

Correspondence: Sang Woo Kim, M.D.

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.

Key Words: Lymphocytic hypophysitis;Pituitary adenoma;Pregnancy