IgG4-related Hypophysitis with Subtle Hypopituitarism in an Elderly Diabetic Patient: Is Treatment or Observation Preferable?

A 70-year-old man with diabetes mellitus presented with an enlarged pituitary stalk in 2014. IgG4-related parotitis and submandibular sialoadenitis were diagnosed in 2012. He denied any symptoms related to a pituitary mass. His visual field was intact, and his hypopituitarism was subtle. The serum I...

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Autores principales: Kawasaki, Motoki, Tsujino, Motoyoshi, Sato, Fuminori, Sakurada, Maya, Nishida, Kenji, Kise, Takayasu, Hijioka, Yuko, Ishizawa, Mitsugu, Enatsu, Kazuaki, Ogawa, Yoshihiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2017
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5675934/
https://www.ncbi.nlm.nih.gov/pubmed/28924128
http://dx.doi.org/10.2169/internalmedicine.8851-17
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author Kawasaki, Motoki
Tsujino, Motoyoshi
Sato, Fuminori
Sakurada, Maya
Nishida, Kenji
Kise, Takayasu
Hijioka, Yuko
Ishizawa, Mitsugu
Enatsu, Kazuaki
Ogawa, Yoshihiro
author_facet Kawasaki, Motoki
Tsujino, Motoyoshi
Sato, Fuminori
Sakurada, Maya
Nishida, Kenji
Kise, Takayasu
Hijioka, Yuko
Ishizawa, Mitsugu
Enatsu, Kazuaki
Ogawa, Yoshihiro
author_sort Kawasaki, Motoki
collection PubMed
description A 70-year-old man with diabetes mellitus presented with an enlarged pituitary stalk in 2014. IgG4-related parotitis and submandibular sialoadenitis were diagnosed in 2012. He denied any symptoms related to a pituitary mass. His visual field was intact, and his hypopituitarism was subtle. The serum IgG4 level was elevated. A lip biopsy revealed strong fibrosis and hyper-infiltration of IgG4-positive plasma cells. Based on these findings, IgG4-related hypophysitis was diagnosed. The patient was carefully followed without specific intervention. His clinical condition showed no change until December 2016, suggesting a stable, natural course. Care should be taken when considering glucocorticoid therapy, especially for elderly diabetic patients, given possible side effects.
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spelling pubmed-56759342017-11-13 IgG4-related Hypophysitis with Subtle Hypopituitarism in an Elderly Diabetic Patient: Is Treatment or Observation Preferable? Kawasaki, Motoki Tsujino, Motoyoshi Sato, Fuminori Sakurada, Maya Nishida, Kenji Kise, Takayasu Hijioka, Yuko Ishizawa, Mitsugu Enatsu, Kazuaki Ogawa, Yoshihiro Intern Med Case Report A 70-year-old man with diabetes mellitus presented with an enlarged pituitary stalk in 2014. IgG4-related parotitis and submandibular sialoadenitis were diagnosed in 2012. He denied any symptoms related to a pituitary mass. His visual field was intact, and his hypopituitarism was subtle. The serum IgG4 level was elevated. A lip biopsy revealed strong fibrosis and hyper-infiltration of IgG4-positive plasma cells. Based on these findings, IgG4-related hypophysitis was diagnosed. The patient was carefully followed without specific intervention. His clinical condition showed no change until December 2016, suggesting a stable, natural course. Care should be taken when considering glucocorticoid therapy, especially for elderly diabetic patients, given possible side effects. The Japanese Society of Internal Medicine 2017-09-15 2017-10-15 /pmc/articles/PMC5675934/ /pubmed/28924128 http://dx.doi.org/10.2169/internalmedicine.8851-17 Text en Copyright © 2017 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/ The Internal Medicine is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Kawasaki, Motoki
Tsujino, Motoyoshi
Sato, Fuminori
Sakurada, Maya
Nishida, Kenji
Kise, Takayasu
Hijioka, Yuko
Ishizawa, Mitsugu
Enatsu, Kazuaki
Ogawa, Yoshihiro
IgG4-related Hypophysitis with Subtle Hypopituitarism in an Elderly Diabetic Patient: Is Treatment or Observation Preferable?
title IgG4-related Hypophysitis with Subtle Hypopituitarism in an Elderly Diabetic Patient: Is Treatment or Observation Preferable?
title_full IgG4-related Hypophysitis with Subtle Hypopituitarism in an Elderly Diabetic Patient: Is Treatment or Observation Preferable?
title_fullStr IgG4-related Hypophysitis with Subtle Hypopituitarism in an Elderly Diabetic Patient: Is Treatment or Observation Preferable?
title_full_unstemmed IgG4-related Hypophysitis with Subtle Hypopituitarism in an Elderly Diabetic Patient: Is Treatment or Observation Preferable?
title_short IgG4-related Hypophysitis with Subtle Hypopituitarism in an Elderly Diabetic Patient: Is Treatment or Observation Preferable?
title_sort igg4-related hypophysitis with subtle hypopituitarism in an elderly diabetic patient: is treatment or observation preferable?
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5675934/
https://www.ncbi.nlm.nih.gov/pubmed/28924128
http://dx.doi.org/10.2169/internalmedicine.8851-17
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