IgG4-related hypophysitis with subtle hypopituitarism in an elderly diabetic patient: Is treatment or observation preferable?

Motoki Kawasaki; Motoyoshi Tsujino; Fuminori Sato; Maya Sakurada; Kenji Nishida; Takayasu Kise; Yuko Hijioka; Mitsugu Ishizawa; Kazuaki Enatsu; Yoshihiro Ogawa

doi:10.2169/internalmedicine.8851-17

IgG4-related hypophysitis with subtle hypopituitarism in an elderly diabetic patient: Is treatment or observation preferable?

Motoki Kawasaki, Motoyoshi Tsujino, Fuminori Sato, Maya Sakurada, Kenji Nishida, Takayasu Kise, Yuko Hijioka, Mitsugu Ishizawa, Kazuaki Enatsu, Yoshihiro Ogawa

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

Abstract

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.

Original language	English
Pages (from-to)	2733-2738
Number of pages	6
Journal	Internal Medicine
Volume	56
Issue number	20
DOIs	https://doi.org/10.2169/internalmedicine.8851-17
Publication status	Published - 2017
Externally published	Yes

All Science Journal Classification (ASJC) codes

Internal Medicine

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This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.2169/internalmedicine.8851-17

Cite this

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title = "IgG4-related hypophysitis with subtle hypopituitarism in an elderly diabetic patient: Is treatment or observation preferable?",

abstract = "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.",

author = "Motoki Kawasaki and Motoyoshi Tsujino and Fuminori Sato and Maya Sakurada and Kenji Nishida and Takayasu Kise and Yuko Hijioka and Mitsugu Ishizawa and Kazuaki Enatsu and Yoshihiro Ogawa",

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doi = "10.2169/internalmedicine.8851-17",

language = "English",

volume = "56",

pages = "2733--2738",

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TY - JOUR

T1 - IgG4-related hypophysitis with subtle hypopituitarism in an elderly diabetic patient

T2 - Is treatment or observation preferable?

AU - Kawasaki, Motoki

AU - Tsujino, Motoyoshi

AU - Sato, Fuminori

AU - Sakurada, Maya

AU - Nishida, Kenji

AU - Kise, Takayasu

AU - Hijioka, Yuko

AU - Ishizawa, Mitsugu

AU - Enatsu, Kazuaki

AU - Ogawa, Yoshihiro

PY - 2017

Y1 - 2017

N2 - 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.

AB - 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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JO - Internal Medicine

JF - Internal Medicine

IS - 20

ER -

IgG4-related hypophysitis with subtle hypopituitarism in an elderly diabetic patient: Is treatment or observation preferable?

Abstract

All Science Journal Classification (ASJC) codes

UN SDGs

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