AI Article Synopsis

  • A 70-year-old man with diabetes had an enlarged pituitary stalk in 2014, previously diagnosed with IgG4-related conditions in 2012 but without symptoms from the pituitary mass.
  • Elevated serum IgG4 and a lip biopsy indicated strong fibrosis and IgG4-positive plasma cell infiltration, leading to a diagnosis of IgG4-related hypophysitis.
  • The patient was monitored over time, showing no significant changes in condition, and a cautious approach to glucocorticoid therapy was emphasized due to potential side effects in elderly diabetic patients.

Article 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.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5675934PMC
http://dx.doi.org/10.2169/internalmedicine.8851-17DOI Listing

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