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Lymphocytic Hypophysitis: Associated With Antiparietal Cell Antibodies and Vitamin B12 Deficiency

Lymphocytic Hypophysitis: Associated With Antiparietal Cell Antibodies and Vitamin B12 Deficiency Abstract • Lymphocytic hypophysitis has been recognized as a distinct clinicopathologic entity. It is a cause of hypopituitarism in the postpartum period and is believed to have an autoimmune pathogenesis. We treated a patient with lymphocytic hypophysitis with two unique features. First, this patient had had a prolactin level of 101 ng/mL (normal, 0 to 25 ng/mL). To our knowledge, this degree of elevation has not been previously reported and is a level that might cause confusion with prolactin-secreting pituitary adenomas. Second, this patient had positive titers for antiparietal cell antibodies in conjunction with a low vitamin B12 level and anemia. To our knowledge, this is the first report of a clinically important autoantibody to extrapituitary tissue in a living patient with lymphocytic hypophysitis. (Arch Intern Med 1983;143:1794-1795) References 1. Asa SL, Bilbao JM, Kovacs K, et al: Lymphocytic hypophysitis of pregnancy resulting in hypopituitarism: A distinct clinicopathologic entity. Ann Intern Med 1981;95:166-171.Crossref 2. Topliss DJ, Volpe R: Lymphocytic hypophysitis. Ann Intern Med 1981;95:227-228.Crossref 3. Mayfield RK, Levine JH, Gordon L, et al: Lymphoid adenohypophysitis presenting as a pituitary tumor. Am J Med 1980;69:619-623. 4. Portocarrero CJ, Robinson AG, Taylor AL, et al: Lymphoid hypophysitis: An unusual case of hyperprolactinemia and enlarged sella turcica. JAMA 1981;246:1811-1822.Crossref 5. Baskin DS, Townsend JJ, Wilson CB: Lymphocytic adenohypophysitis of pregnancy simulating a pituitary adenoma: A distinct pathological entity. J Neurosurg 1982;56:148-153.Crossref 6. Schlechte J, Vangilder J, Sherman B: Predictors of the outcome of transsphenoidal surgery for prolactin-secreting pituitary adenomas. J Clin Endocrinol Metabol 1981;52:785-789.Crossref 7. Cebelin MS, Velasco ME, De Las Mulas JM, et al: Galactorrhea associated with lymphocytic adenohypophysitis. Br J Obstet Gynaecol 1981;88:675-680.Crossref 8. Levine S: Allergic adenohypophysitis: New experimental disease of the pituitary gland. Science 1967;158:1190-1191.Crossref 9. Goudie RB, Pinkerton PH: Anterior hypophysitis and Hashimoto's disease in a young woman. J Pathol Bacteriol 1962;83:584-585.Crossref 10. Hume R, Roberts GH: Hypophysitis and hypopituitarism: Report of a case. Br Med J 1967;2:548-550.Crossref 11. Lack EE: Lymphoid `hypophysitis' with end organ insufficiency. Arch Pathol Lab Med 1975;99:215-219. 12. Bottazzo GF, Pouplard A, Florin-Christensen A, et al: Autoantibodies to prolactin-secreting cells of human pituitary. Lancet 1975; 1:1075. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Lymphocytic Hypophysitis: Associated With Antiparietal Cell Antibodies and Vitamin B12 Deficiency

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Publisher
American Medical Association
Copyright
Copyright © 1983 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1983.00350090176032
Publisher site
See Article on Publisher Site

Abstract

Abstract • Lymphocytic hypophysitis has been recognized as a distinct clinicopathologic entity. It is a cause of hypopituitarism in the postpartum period and is believed to have an autoimmune pathogenesis. We treated a patient with lymphocytic hypophysitis with two unique features. First, this patient had had a prolactin level of 101 ng/mL (normal, 0 to 25 ng/mL). To our knowledge, this degree of elevation has not been previously reported and is a level that might cause confusion with prolactin-secreting pituitary adenomas. Second, this patient had positive titers for antiparietal cell antibodies in conjunction with a low vitamin B12 level and anemia. To our knowledge, this is the first report of a clinically important autoantibody to extrapituitary tissue in a living patient with lymphocytic hypophysitis. (Arch Intern Med 1983;143:1794-1795) References 1. Asa SL, Bilbao JM, Kovacs K, et al: Lymphocytic hypophysitis of pregnancy resulting in hypopituitarism: A distinct clinicopathologic entity. Ann Intern Med 1981;95:166-171.Crossref 2. Topliss DJ, Volpe R: Lymphocytic hypophysitis. Ann Intern Med 1981;95:227-228.Crossref 3. Mayfield RK, Levine JH, Gordon L, et al: Lymphoid adenohypophysitis presenting as a pituitary tumor. Am J Med 1980;69:619-623. 4. Portocarrero CJ, Robinson AG, Taylor AL, et al: Lymphoid hypophysitis: An unusual case of hyperprolactinemia and enlarged sella turcica. JAMA 1981;246:1811-1822.Crossref 5. Baskin DS, Townsend JJ, Wilson CB: Lymphocytic adenohypophysitis of pregnancy simulating a pituitary adenoma: A distinct pathological entity. J Neurosurg 1982;56:148-153.Crossref 6. Schlechte J, Vangilder J, Sherman B: Predictors of the outcome of transsphenoidal surgery for prolactin-secreting pituitary adenomas. J Clin Endocrinol Metabol 1981;52:785-789.Crossref 7. Cebelin MS, Velasco ME, De Las Mulas JM, et al: Galactorrhea associated with lymphocytic adenohypophysitis. Br J Obstet Gynaecol 1981;88:675-680.Crossref 8. Levine S: Allergic adenohypophysitis: New experimental disease of the pituitary gland. Science 1967;158:1190-1191.Crossref 9. Goudie RB, Pinkerton PH: Anterior hypophysitis and Hashimoto's disease in a young woman. J Pathol Bacteriol 1962;83:584-585.Crossref 10. Hume R, Roberts GH: Hypophysitis and hypopituitarism: Report of a case. Br Med J 1967;2:548-550.Crossref 11. Lack EE: Lymphoid `hypophysitis' with end organ insufficiency. Arch Pathol Lab Med 1975;99:215-219. 12. Bottazzo GF, Pouplard A, Florin-Christensen A, et al: Autoantibodies to prolactin-secreting cells of human pituitary. Lancet 1975; 1:1075.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Sep 1, 1983

References