Postpartum Granulomatous Hypophysitis: A Case Study, Review of the Literature, and Discussion of Pathogenesis

Hypophysitis is a rare inflammatory condition of the pituitary gland that has three main histologic subtypes: lymphocytic hypophysitis (LH), granulomatous hypophysitis (GH), and xanthomatous hypophysitis (XH). Among these, LH is the most common and is strongly associated with the postpartum state, w...

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Main Authors: Upasana Joneja, D. Craig Hooper, James J. Evans, Mark T. Curtis
Format: Article
Language:English
Published: Hindawi Limited 2016-01-01
Series:Case Reports in Pathology
Online Access:http://dx.doi.org/10.1155/2016/7510323
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spelling doaj-f645c7381c63442c881dcac3728b3fc12020-11-24T22:52:04ZengHindawi LimitedCase Reports in Pathology2090-67812090-679X2016-01-01201610.1155/2016/75103237510323Postpartum Granulomatous Hypophysitis: A Case Study, Review of the Literature, and Discussion of PathogenesisUpasana Joneja0D. Craig Hooper1James J. Evans2Mark T. Curtis3Department of Pathology, Cell Biology and Anatomy, Thomas Jefferson University Hospitals, Philadelphia, PA, USADepartment of Cancer Biology, Thomas Jefferson University Hospitals, Philadelphia, PA, USADepartment of Neurosurgery, Thomas Jefferson University Hospitals, Philadelphia, PA, USADepartment of Pathology, Cell Biology and Anatomy, Thomas Jefferson University Hospitals, Philadelphia, PA, USAHypophysitis is a rare inflammatory condition of the pituitary gland that has three main histologic subtypes: lymphocytic hypophysitis (LH), granulomatous hypophysitis (GH), and xanthomatous hypophysitis (XH). Among these, LH is the most common and is strongly associated with the postpartum state, while XH is the least common. Many hypophysitis cases have been reported in the literature but only a few cases of postpartum GH have been discussed. Here, we describe a case of GH in a 24-year-old female presenting eleven days postpartum. We also review the current literature on postpartum GH and discuss the possible alterations in the immune environment during and after pregnancy that could explain this phenomenon. With more cases of GH being reported, the commonalities of female predominance, postpartum time of presentation, and occasional spontaneous resolution between LH and GH lend support to the theory that these two diseases likely represent spectrums of a single immunologic disorder.http://dx.doi.org/10.1155/2016/7510323
collection DOAJ
language English
format Article
sources DOAJ
author Upasana Joneja
D. Craig Hooper
James J. Evans
Mark T. Curtis
spellingShingle Upasana Joneja
D. Craig Hooper
James J. Evans
Mark T. Curtis
Postpartum Granulomatous Hypophysitis: A Case Study, Review of the Literature, and Discussion of Pathogenesis
Case Reports in Pathology
author_facet Upasana Joneja
D. Craig Hooper
James J. Evans
Mark T. Curtis
author_sort Upasana Joneja
title Postpartum Granulomatous Hypophysitis: A Case Study, Review of the Literature, and Discussion of Pathogenesis
title_short Postpartum Granulomatous Hypophysitis: A Case Study, Review of the Literature, and Discussion of Pathogenesis
title_full Postpartum Granulomatous Hypophysitis: A Case Study, Review of the Literature, and Discussion of Pathogenesis
title_fullStr Postpartum Granulomatous Hypophysitis: A Case Study, Review of the Literature, and Discussion of Pathogenesis
title_full_unstemmed Postpartum Granulomatous Hypophysitis: A Case Study, Review of the Literature, and Discussion of Pathogenesis
title_sort postpartum granulomatous hypophysitis: a case study, review of the literature, and discussion of pathogenesis
publisher Hindawi Limited
series Case Reports in Pathology
issn 2090-6781
2090-679X
publishDate 2016-01-01
description Hypophysitis is a rare inflammatory condition of the pituitary gland that has three main histologic subtypes: lymphocytic hypophysitis (LH), granulomatous hypophysitis (GH), and xanthomatous hypophysitis (XH). Among these, LH is the most common and is strongly associated with the postpartum state, while XH is the least common. Many hypophysitis cases have been reported in the literature but only a few cases of postpartum GH have been discussed. Here, we describe a case of GH in a 24-year-old female presenting eleven days postpartum. We also review the current literature on postpartum GH and discuss the possible alterations in the immune environment during and after pregnancy that could explain this phenomenon. With more cases of GH being reported, the commonalities of female predominance, postpartum time of presentation, and occasional spontaneous resolution between LH and GH lend support to the theory that these two diseases likely represent spectrums of a single immunologic disorder.
url http://dx.doi.org/10.1155/2016/7510323
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