A Rare Case of Hypophysitis Due to Tuberculosis with an Atypical Presentation of Normal Pituitary Markers

Abstract

Abstract Hypophysitis developing secondary to tuberculosis is a very rare clinical entity. Hypophysitis occurs because of inflammation and it may affect the anterior, infundibulum, posterior, or entire pituitary gland. Here, we are presenting a case of a young male having tubercular meningitis who was taking antitubercular treatment for the last 2 months and was having disseminated tuberculosis. The patient presented with severe headache with fever and 4–5 episodes of vomiting. The patient presented with the affection of consciousness in the form of confusion, irritability, and disorientation. High-resolution CT thorax was suggestive of pulmonary tuberculosis (Koch’s) with centrilobular nodules and a tree-in-bud appearance. Magnetic resonance imaging brain showed prominent leptomeningeal enhancement with an enlarged pituitary gland with enlarged enhancing stalk suggestive of hypophysitis. The hypophysitis case developing secondary to tuberculosis as a very rare entity is discussed in this case report. This case is also an atypical presentation wherein the pituitary markers are normal in hypophysitis.