Primary antiphospholipid syndrome and panhypopituitarism: a unique presentation

Lymphocytic hypophysitis (LH) has been described previously in systemic lupus erythematosus (1.3%), Sjogren's syndrome (0.8%). Lymphocytic hypo physitis (LH) is rarely associated with rheumatic diseases, although three cases of pituitary disease associated with antiphospholipid syndrome (APS) have been described. Here, we report a possible association between APS and LH for the first time. A 34-yr-old woman with primary APS presented with polyuria, polydipsia, hypernatremia and impaired vision. Her hormone profile was compatible with panhypopituitarism, and sellar magnetic resonance imaging (MRI) depicted a normal pituitary gland with a thickened and displaced stalk and infundibulum portion. Hormone replacement was started, and the patient experienced a good clinical evolution.