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Exp Clin Endocrinol Diabetes 2011; 119(10): 633-635
DOI: 10.1055/s-0031-1284366
Article
© J. A. Barth Verlag in George Thieme Verlag KG Stuttgart · New York

Hypopituitarism in a HIV Affected Patient

B. Harbeck
1   University Hospital of Lübeck, 1. Department of Medicine, Lübeck, Germany
,
S. Klose
2   Magdeburg University Medical School, Division of Endocrinology and Metabolism, Magdeburg, Germany
,
M. Buchfelder
3   Friedrich-Alexander-University of Erlangen-Nürnberg, Department of Neurosurgery, Erlangen, Germany
,
G. Brabant
4   University of Manchester, Department of Endocrinology, Manchester, United Kingdom
,
H. Lehnert
1   University Hospital of Lübeck, 1. Department of Medicine, Lübeck, Germany
› Author Affiliations
Further Information

Publication History

received 01 January 2011
firstdecision 28 May 2011

accepted 12 July 2011

Publication Date:
15 September 2011 (online)

Also available at
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Abstract

Background:

The clinical picture of pituitary abscesses may resemble features of other pituitary pathologies including endocrine deficiencies. The characteristic radiological changes, namely the ring enhancement, may aid in the diagnostic work-up of this very rare condition.

Case Report:

A 40-year-old patient with longstanding HIV infection presented with headache and fatigue. Testing for pituitary function confirmed panhypopitutarism. MRI scanning demonstrated an inhomogeneous pituitary gland with ring-like enhancement and sphenoid sinus mucosa thickening. Transsphenoidal surgery was performed. Histologically CD68 positive macrophages were found supporting the diagnosis of infectious hypophysitis. Under hormone replacement therapy and retroviral treatment the patient clinically normalized.

Conclusion:

A pituitary abscess due to infectious hypophysitis is a rare cause of pituitary failure. Diagnostic signs on imaging may help to rapidly distinguish the cause of pituitary deficiency in patients with HIV infection.

Key words

hypopituitarism - pituitary adenoma - GH Adrenal gland
 

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