A rare etiology of autoimmune hypophysitis

Yesmine Elloumi; Khouloud Boujelben; Salah Dhoha Ben; Hamdi Frikha; Abdallah Ameni Ben; Hadjkacem Faten; Nadia Charfi; Mouna Mnif; Mohamed Abid; Mouna Elleuch; Majdoub Nabila Rekik

doi:10.1530/endoabs.110.EP1174

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Endocrine Abstracts (2025) 110 EP1174 | DOI: 10.1530/endoabs.110.EP1174

ECEESPE2025 ePoster Presentations Pituitary, Neuroendocrinology and Puberty (220 abstracts)

A rare etiology of autoimmune hypophysitis

Yesmine Elloumi ¹ , Khouloud Boujelben ¹ , Dhoha Ben Salah ¹ , Hamdi Frikha ¹ , Ameni Ben Abdallah ¹ , Hadjkacem Faten ¹ , Nadia Charfi ¹ , Mouna Mnif ¹ , Mohamed Abid ¹ , Mouna Elleuch ¹ & Nabila Rekik Majdoub ¹

Author affiliations

¹Hedi Chaker University Hospital, Endocrinology Department, Sfax, Tunisia.

JOINT1499

Background: Chemotherapy is widely used to treat various cancers, but it can also result in a range of side effects, some of which are rare and underrecognized. Autoimmune hypophysitis, an inflammation of the pituitary gland, is an uncommon complication.

Case Report: A 47-year-old woman with a history of hypertension and breast cancer, treated with total mastectomy, adjuvant radiotherapy, and chemotherapy (cyclophosphamide, paclitaxel, and epirubicin), presented with palpitations. ECG showed a sinus tachycardia. A TSH test was ordered, revealing a low value of 0.06 μIU/ml, and she was referred to our endocrinology department. On examination, the patient was in a state of eucortisism, with a blood pressure of 14/10 cmHg, in an euthyroid state, without galactorrhea or exophthalmos. She has been menopausal for one year. Further tests showed a controlled TSH level of 1 μIU/ml, FT4 at 10 pmol/l(normal range: 7-16), morning cortisol at 44.5 μg/l, FSH at 72.1 mUI/ml, LH at 47.8 mUI/ml, and prolactin at 5.61 ng/ml. A Synacthen test confirmed adrenal insufficiency, and ACTH was measured at 13.5 pg/ml (normal range: 7-63), suggesting a central origin. The patient was started on hydrocortisone replacement. An MRI of the hypothalamo-pituitary region revealed a bulging aspect of the pituitary gland, with no focal lesions detectable, and a thin pituitary stalk, consistent with autoimmune hypophysitis.

Conclusion: This case report highlights a rare instance of chemotherapy-induced autoimmune hypophysitis, emphasizing the importance of early recognition and timely intervention.