Occurrence of IgG4-related Hypophysitis Lacking IgG4-bearing Plasma Cell Infiltration during Steroid Therapy
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- Ohkubo Yohsuke
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Shinshu University School of Medicine, Japan
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- Sekido Takashi
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Shinshu University School of Medicine, Japan
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- Takeshige Keiko
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Shinshu University School of Medicine, Japan
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- Ishi Hiroaki
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Shinshu University School of Medicine, Japan
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- Takei Masahiro
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Shinshu University School of Medicine, Japan
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- Nishio Shin-ichi
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Shinshu University School of Medicine, Japan
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- Yamazaki Masanori
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Shinshu University School of Medicine, Japan
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- Komatsu Mitsuhisa
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Shinshu University School of Medicine, Japan
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- Kawa Shigeyuki
- Center for Health, Safety, and Environmental Management, Shinshu University, Japan
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- Suzuki Satoru
- Department of Thyroid and Endocrinology, School of Medicine, Fukushima Medical University, Japan
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抄録
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.<br>
収録刊行物
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- Internal Medicine
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Internal Medicine 53 (7), 753-757, 2014
一般社団法人 日本内科学会