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CASE REPORT
Mycophenolate mofetil treatment in a patient with recurrent lymphocytic hypophysitis
  1. Hiroshi Sawachika,
  2. Shoko Kodama,
  3. Tomoyuki Mukai,
  4. Yoshitaka Morita
  1. Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
  1. Correspondence to Dr Yoshitaka Morita, morita{at}med.kawasaki-m.ac.jp

Summary

Lymphocytic hypophysitis (LHP) is a relatively rare disease characterised by lymphocytic infiltration of the pituitary gland, resulting in pituitary dysfunction. LHP is generally responsive to corticosteroid therapy, but cases with recurrence require clinicians to select second-line therapy. We report here the case of a 58-year-old patient with LHP who developed panhypopituitarism and bitemporal hemianopia. He responded to prednisolone 40 mg/day but relapsed during tapering. The prednisolone dose was increased again and mycophenolate mofetil (MMF) was added. Thereafter, over the course of 1 year, prednisolone was tapered to 8 mg/day without relapse. Because of the rarity of LHP, there are no standard treatment protocols that support the choice of a specific immunosuppressive drug. MMF was effective for recurrent LHP in our case. Further accumulation of cases is needed to establish the standard treatment for this disease.

  • pituitary disorders
  • therapeutic indications

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Footnotes

  • Contributors HS, SK and YM involved in the conception or design of the work. HS and SK are responsible for the acquisition of data. All authors were responsible for analysis and interpretation of data and drafted the manuscript or revised.

  • Competing interests All authors have received scholarship donations from AbbVie, Actelion, Astellas, Bristol-Myers, Chugai, Daiichi-Sankyo, Eisai, Eli Lilly, Japan Blood Products Organization, Mitsubishi-Tanabe, Pfizer, Shionogi, Takeda,Teijin, and UCB.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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