Pituitary Abscess as Manifestation of IgG4-Related Hypophysitis: A Case Report

Abstract IgG4-related disease (IgG4-RD) is an immune-mediated fibroinflammatory condition with heterogeneous organ-specific manifestations. hypophysitis results from pituitary involvement and represents a rare neuro-ophthalmic complication of IgG4-RD, but the presentation as abscess exceptional. We report case 38-year-old otherwise healthy woman 3-year history relapsing sterile repeatedly treated neurosurgery antimicrobials. Histological re-examination biopsy specimens revealed dense inflammatory infiltrate rich in IgG4-positive plasma cells. Serum IgG4 levels were normal circulating plasmablasts increased. A diagnosis was made patient high-dose steroid pulse therapy subsequent reduction lesion resolution symptoms. This highlights how diagnostic intuition on basis histopathology has changed management prompt dramatic response to therapy.