Hypopituitarism in a HIV Affected Patient

B. Harbeck; S. Klose; M. Buchfelder; G. Brabant; H. Lehnert

doi:10.1055/s-0031-1284366

Experimental and Clinical Endocrinology & Diabetes, Table of Contents

Exp Clin Endocrinol Diabetes 2011; 119(10): 633-635
DOI: 10.1055/s-0031-1284366

Article

Hypopituitarism in a HIV Affected Patient

B. Harbeck

¹University Hospital of Lübeck, 1. Department of Medicine, Lübeck, Germany

,

S. Klose

²Magdeburg University Medical School, Division of Endocrinology and Metabolism, Magdeburg, Germany

,

M. Buchfelder

³Friedrich-Alexander-University of Erlangen-Nürnberg, Department of Neurosurgery, Erlangen, Germany

,

G. Brabant

⁴University of Manchester, Department of Endocrinology, Manchester, United Kingdom

,

H. Lehnert

¹University Hospital of Lübeck, 1. Department of Medicine, Lübeck, Germany

› Author Affiliations

Abstract

Background:

The clinical picture of pituitary abscesses may resemble features of other pituitary pathologies including endocrine deficiencies. The characteristic radiological changes, namely the ring enhancement, may aid in the diagnostic work-up of this very rare condition.

Case Report:

A 40-year-old patient with longstanding HIV infection presented with headache and fatigue. Testing for pituitary function confirmed panhypopitutarism. MRI scanning demonstrated an inhomogeneous pituitary gland with ring-like enhancement and sphenoid sinus mucosa thickening. Transsphenoidal surgery was performed. Histologically CD68 positive macrophages were found supporting the diagnosis of infectious hypophysitis. Under hormone replacement therapy and retroviral treatment the patient clinically normalized.

Conclusion:

A pituitary abscess due to infectious hypophysitis is a rare cause of pituitary failure. Diagnostic signs on imaging may help to rapidly distinguish the cause of pituitary deficiency in patients with HIV infection.

Key words

hypopituitarism - pituitary adenoma - GH Adrenal gland

Full Text

References

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