ECEESPE2025 ePoster Presentations Pituitary, Neuroendocrinology and Puberty (220 abstracts)
Development of empty sella in neurosarcoidosis; a case report
Hemmat El Haddad 1 , Amr El Meligi 1 , Rokaya Abdel Aziz 1 , Randa Salam 1 , Alaa Abdallah 1 , Salma Mohamed 1 , Tasneem Halaby 1 , Mirette Makram 1 & Ahmed Atef 1
1Cairo University, Cairo, Egypt
JOINT426
Introduction: Sarcoidosis is a multisystem disorder marked by noncaseating granulomatous lesions. Central nervous system involvement, estimated in 5–15% of sarcoidosis patients, localized most commonly to the leptomeninges, cranial nerves or the pituitary gland and hypothalamus, Sellar sarcoidosis comprising less than 1%, presenting with neuroendocrine related features such as diabetes insipidus, hypothyroidism, hypoadrelinism or hyperprolactineamia.
Case report: A 70-year-old woman with a medical history of hypothyroidism on levothyroxine 100 µg/day The patient was diagnosed as pulmonary sarcoidosis four years ago Multi slice CT showed mild diffuse pulmonary interstitial changes with right upper lateral area of subsegmental atelectasis and scattered atelectatic bands likely postinflammatory, focal liver lesions 2x2 cm FDG-PET/CT showed multiple uptakes in lung, liver, pitutary gland bronchoscpony revealed non caseating granuloma. The patient was diagnosed systemic sarcoidosis with propable pitutary neurosarcoidosis she was treated with prednisone(1mg/kg/day) and methotrexate 10mg once a week Follow up multislice CT abdomen showed only mildly enlarged fatty liver with no focal lesions & right renal cortical cyst. Prednisone was tapered after 1 year The dose of eltroxin decreased a couple of years later into 50mg due to constant decrease of TSH which was explained as overcorrection. A year later, She presented to outpatient clinic with weakness, fatigue, anorexia for 3 weeks Examination revealed Bp 110/80 but with orthostatic hypotension, pulse 70/minute, weight 59 kg Labs showed TSH 0.20(0.5-5mIu/l), FT4 0.52 (5-12ug/dl), Serum cortisol AM. 2.6 (5-25 mg/dl), consistent with hypopituitarism MRI pituitary showed partial empty sella with accentuated CSF in the suprasellar cistern compressing the gland against the sellar floor Her eltroxin dose was adjusted to be 75mg/day & she was given hydrocortisone 15 mg.
Conclusions: This case report demonstrates the evolution of a pituitary hyperplasia in a patient with neurosarcoidosis into an empty sella this condition is rarely mentioned among the causes of empty sella.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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