Abstract | PURPOSE: METHODS: Case description and review of 15 cases reported in the literature. A 40 year old male was diagnosed with IgG-4 related disease based on pituitary and lacrimal gland biopsies associated with raised serum concentration of IgG4. The patient was commenced on prednisolone 30 mg/day, as rapid response to prednisolone treatment has been described in the literature for other cases of IgG4-related hypophysitis. Over the next 3 months, prednisolone treatment resulted in a reduction of serum IgG4 levels, but repeat MRI scan showed an enlarging pituitary mass with new optic nerve compression. Azathioprine 75 mg twice daily was commenced and in the subsequent 3 months, IgG4 levels normalised (0.58 g/L) and MRI scan showed 50% shrinkage of the pituitary mass. After 10 months of azathioprine treatment the MRI showed a normal sized pituitary but persistence of the infraorbital nerve thickening. CONCLUSIONS:
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Authors | Carmela Caputo, Ali Bazargan, Penelope A McKelvie, Tom Sutherland, Charles S Su, Warrick J Inder |
Journal | Pituitary
(Pituitary)
Vol. 17
Issue 3
Pg. 251-6
(Jun 2014)
ISSN: 1573-7403 [Electronic] United States |
PMID | 23794123
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Adrenal Cortex Hormones
- Antimetabolites, Antineoplastic
- Immunoglobulin G
- Azathioprine
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Topics |
- Adrenal Cortex Hormones
(therapeutic use)
- Adult
- Antimetabolites, Antineoplastic
(therapeutic use)
- Azathioprine
(therapeutic use)
- Humans
- Immunoglobulin G
(genetics)
- Lacrimal Apparatus
(pathology)
- Male
- Pituitary Diseases
(drug therapy, etiology, pathology)
- Pituitary Gland
(pathology)
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