Abstract
A 40-year-old female presented to the ED with a history of intermittent headaches
since a vaginal delivery 8 days prior. Her pregnancy was unremarkable and was not
complicated by pre-eclampsia. She did not present with signs or symptoms consistent
with postdural puncture headache or pre-eclampsia. Her delivery was not complicated
by hypotension or post-partum hemorrhage. By chance, she was found to be hyponatremic
and admitted to internal medicine for further work-up. She was diagnosed with postpartum
lymphocytic adenohypophysitis and treated with steroids. She was discharged with a
steroid taper and had complete resolution on follow up.
Lymphocytic hypophysitis (LH), or commonly known as autoimmune hypophysitis, is a
rare inflammatory condition affecting the pituitary gland. Acute LH can result in
sudden death as demonstrated in some case reports. The most common symptom in >50%
of cases is headache. First-line pharmacological treatment consists of high-dose corticosteroids
and is effective in reducing pituitary size and improving endocrine insufficiency
in 75% of cases.
LH is a potential cause of postpartum headache that can be easily screened for with
history and routine bloodwork and has good outcomes with early intervention.
LH should be added to the differential for postpartum headaches presenting to the
emergency department and routine blood work should be considered for all postpartum
headaches.
Keywords
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References
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Article Info
Publication History
Published online: July 18, 2020
Accepted:
July 8,
2020
Received in revised form:
July 4,
2020
Received:
June 2,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
