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Post-partum Lymphocytic Hypophysitis in Ethiopian Woman

Amare Gulilat, Getahun Tarekegn, Abebe Mekonnen, Tewodros Endale

A 28 year-old young woman who was referred from Bahir Dar, Ethiopia for possible neurosurgical evaluation and management after she presented with headache and failure to lactate one month following delivery.The initial hormonal analysis was consistent with hypopituitarism.The magnetic resonance imaging (MRI) of the Brain done initially showed diffuse enlargement of the pituitary gland and thickening of the pituitary stalk. Most of the pituitary axes recovered after one month of hormonal replacement therapy.The follow-up MRI done after four weeks showed resolution of pituitary gland enlargement and stalk thickening.Based on clinical presentation, pituitary hormonal insufficiency and Brain MRI findings,the diagnosis of lymphocytic hypophysitis was made. Lymphocytic hypophysitis is a rare disease in which inflammation of the pituitary gland and stalk occurs. It is associated with transient or permanent insufficiency pituitary hormones. It usually occurs in women during third trimester of pregnancy or postpartum period. Systemic corticosteroid treatment at early stage may avoid unnecessary surgery in some cases but there are reported cases of spontaneous resolution.