Secondary hypophysitis

Secondary hypophysitis is an inflammatory condition of the pituitary gland, but is caused by a systemic inflammatory disease. Secondary hypophysitis is often easier to diagnose than primary hypophysitis because patients will have other symptoms related to the underlying disorder. Common systemic inflammatory diseases that can involve the pituitary gland include Langerhans cell histiocytosis, Wegener granulomatosis, Crohn's disease, syphilis, and sarcadosis. Tuberculosis can cause tubercular abscesses that involve the paranasal sinuses and the pituitary fossa, mimicking pituitary tumors. Secondary hypopysitis can also be an inflammatory response to certain medications (such as certain chemotherapeutic drugs) or to a pituitary lesion (such as a Rathke cleft cyst or adenoma).

Symptoms

Langerhans cell histiocytosis

  • Diabetes insipidus
  • Endocrine dysfunction
  • Visual deficits

Wegener granulomatosis

  • Diabetes insipidus
  • Hyperprolactinemia 
  • Panhypopituitarism 

Sarcoidosis

  • Headache
  • Diabetes insipidus
  • Amenorrhea

Treatment

Treatment for secondary hypophysitis is aimed at treating the underlying condition. For hypophysitis secondary to a ruptured Rathke's cleft cyst, a tumor, or an abscess, surgery may be required.