22yr F brought by mother with ch global headache, low mood for 5 yr on BZD under Psychiatrist but symptoms only worsening (cant go College), stepwise approach s/o subcli hypothyroid & hypophysitis low cortisol hormonal assay wnl, after excluding all other causes (primary and secondary) we concluded to rest the diagnosis to ?? Lymphocytic Hypophysitis (mc) & referd her to endocrinologist where the diagnosis was honored, no HistoPath bx done, due to High index of suspension and Rx. Symptoms better 3 mth now givin exams mother cam bak to thank.
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Dr. Heerak
Headache due to pressure effect. Neuropsychiatric manifestations due to HPA axis alteration. Interestingly her blood pressures and blood sugars were WNL , but definitely would hav land up in crisis in stressful conditions infection etc... Conservatively being managed on steroids and will be reassessed 6 monthly if inflammation persists than would be taken up for invasive management along with histopath exm.