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.
CITATION STYLE
Kawasaki, M., Tsujino, M., Sato, F., Sakurada, M., Nishida, K., Kise, T., … Ogawa, Y. (2017). IgG4-related hypophysitis with subtle hypopituitarism in an elderly diabetic patient: Is treatment or observation preferable? Internal Medicine, 56(20), 2733–2738. https://doi.org/10.2169/internalmedicine.8851-17
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