Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
Occurrence of IgG4-related Hypophysitis Lacking IgG4-bearing Plasma Cell Infiltration during Steroid Therapy
Yohsuke OhkuboTakashi SekidoKeiko TakeshigeHiroaki IshiMasahiro TakeiShin-ichi NishioMasanori YamazakiMitsuhisa KomatsuShigeyuki KawaSatoru Suzuki
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2014 Volume 53 Issue 7 Pages 753-757


Eight years after an episode of multiple IgG4-related disease, a pituitary mass with panhypopituitarism and a visual disturbance developed in a 70-year-old man under low-dose steroid therapy. A pituitary biopsy revealed findings of lymphocytic hypophysitis with the absence of IgG4-positive plasma cell infiltration. The serum IgG4 level was unremarkable. Although performing a pituitary biopsy and measuring the serum IgG4 level is crucial for making a diagnosis of IgG4-related hypophysitis, it is occasionally difficult to diagnose the disease in patients treated with steroid therapy, as observed in the present case. Based on a review of the diagnosis, conducting a careful assessment is required, especially in men and elderly patients thought to have solitary hypophysitis.

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© 2014 by The Japanese Society of Internal Medicine
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