Lymphocytic hypophysitis masquerading as transient secondary hyperadrenalism followed by panhypopituitarism

Abstract

Lymphocytic hypophysitis (LH) is a rare inflammatory disease of the pituitary gland. This condition strikingly shows female
preponderance and commonly affects women during pregnancy or in the post-partum period. It’s a clinical presentation and radiological
features may mimic pituitary adenoma. Though its treatment modality is uncertain steroid remains the 1st option for treatment. Here,
we report an unusual case of LHin a 21-year-old female patient where initially, the patient presented with hyperadrenalism and
secondary hyperthyroidism followed by pan-hypopituitarism (Addisonian crisis) which is attributed to initial autoimmune destruction
of the gland followed by subsequent fibrosis. Thus, it is a rare case report which exquisitely explains this rare presentation and such
cases should be investigated thoroughly since there are many differential and response to steroids is remarkable.