Endocrine Abstracts (2011) 26 P220

Normal pregnancy in a woman with history of panhypopituitarism due to lymphocytic hypophysitis

V Dimarakis, C T Tsentidis, A Antoniou-Tsigos & A A Argyropoulos

Nicaea General Hospital, Piraeus, Athens, Greece.

Introduction: Lymphocytic hypophysitis is an uncommon autoimmune disease usually presenting during or just after pregnancy. It may be followed by panhypopituitarism. In such case is extremely rare for a woman to have a normal delivery again.

Case report: We report the case of a 28-year-old woman who had a successful delivery 2 years after lymphocytic hypophysitis which had resulted in panhypopituitarism. The young woman presented with amenorrhea, symptoms of secondary adrenal insufficiency and polyuria several months after her first labor. She reported severe headache which occurred 5 weeks after the labor and lasted for about 1 month. We performed a complete hormonal evaluation of the pituitary gland, which revealed posterior and anterior lobe insufficiency. The MRI findings were consistent with the diagnosis of lymphocytic hypophysitis. The patient was prescribed a full hormone replacement therapy, but after a few months she stopped the estrogen and progesterone therapy by herself. Five months later, she restored normal menses and after two more consecutive months she conceived again. The new pituitary gland hormonal evaluation revealed insufficiency of all other axes. She had a normal pregnancy and labor. She only needed a small increase in hydrocortisone and thyroxin dose at the third trimester.

Conclusion: It is possible for a patient with a history of lymphocytic hypophysitis to conceive and have a normal pregnancy again.

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