Lymphocytic hypophysitis is a rare neuroendocrine disorder characterized by autoimmune inflammation of the pituitary gland, with various degrees of pituitary dysfunction, including permanent hypopituitarism. Histologic findings consist of an initial monoclonal lymphocytic infiltrate, which can heal with minimal sequelae or progress to fibrosis. Ophthalmic manifestations include chiasmal visual field defects secondary to suprasellar extension or, less frequently, diplopia due to invasion of cavernous sinuses. Imaging characteristics and endocrine testing are not specific. The diagnosis should be suspected if a woman who is pregnant or in the peripartum period presents with headache, bitemporal visual field defects, and changes in 1 or more pituitary hormones. Corticosteroids and other immunosuppressive drugs may be needed in some patients. Surgical treatment is typically required if vision is compromised.
Excerpted from BCSC 2020-2021 series: Section 5 - Neuro-Ophthalmology. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.