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

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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 languageEnglish
Pages (from-to)2733-2738
Number of pages6
JournalInternal Medicine
Issue number20
Publication statusPublished - Jan 1 2017
Externally publishedYes


All Science Journal Classification (ASJC) codes

  • Internal Medicine

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