{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T10:29:09Z","timestamp":1786530549550,"version":"build-2736575974"},"reference-count":23,"publisher":"The Endocrine Society","issue":"9","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":16,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Lymphocytic hypophysitis (LYH), attributed to autoimmune mechanisms, typically causes multiple anterior pituitary hormone deficiencies, with corticotroph dysfunction occurring earliest; predominant thyrotroph dysfunction is uncommon. A 65-year-old woman presented with headache, fever, and diplopia. Laboratory tests revealed marked systemic inflammation and cerebrospinal fluid (CSF) pleocytosis. Pituitary magnetic resonance imaging (MRI) demonstrated diffuse enlargement and homogeneous contrast enhancement of the pituitary gland and stalk. Endocrinological evaluation showed paradoxically decreased thyroid-stimulating hormone (TSH) despite low thyroid hormone levels, contrasting with elevated adrenocorticotropic hormone (ACTH) levels. Endocrinological stimulation tests revealed a markedly blunted TSH response, with preserved gonadotropin and growth hormone responses, indicating predominant thyrotroph dysfunction despite preserved corticotroph function. Glucocorticoid therapy resulted in prompt improvement of clinical, laboratory, and MRI findings, with complete recovery of anterior pituitary functions. A presumptive diagnosis of LYH with reversible predominant thyrotroph dysfunction and meningitis secondary to direct extension of pituitary inflammation was established. This case demonstrates that LYH can present with atypical anterior pituitary hormone dysfunction, may be complicated by aseptic meningitis, and requires prompt glucocorticoid therapy for favorable outcomes.<\/jats:p>","DOI":"10.1210\/jcemcr\/luag221","type":"journal-article","created":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T11:31:42Z","timestamp":1785065502000},"source":"Crossref","is-referenced-by-count":0,"title":["Reversible predominant thyrotropin axis dysfunction with meningitis in suspected lymphocytic hypophysitis"],"prefix":"10.1210","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7456-9274","authenticated-orcid":false,"given":"Kohei","family":"Iinuma","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism, Fujiyoshida Municipal Medical Center, Fujiyoshida City, Yamanashi 403-0032 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8946-9475","authenticated-orcid":false,"given":"Ryota","family":"Amano","sequence":"additional","affiliation":[{"name":"Department of Neurology, Fujiyoshida Municipal Medical Center , Fujiyoshida City, Yamanashi 403-0032, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7158-1653","authenticated-orcid":false,"given":"Katsumi","family":"Taki","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Fujiyoshida Municipal Medical Center, Fujiyoshida City, Yamanashi 403-0032 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"issue":"1","key":"2026081205131348300_luag221-B1","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1210\/clinem\/dgab672","article-title":"Hypophysitis, the growing spectrum of a rare pituitary disease","volume":"107","author":"Langlois","year":"2022","journal-title":"J Clin Endocrinol Metab"},{"issue":"6","key":"2026081205131348300_luag221-B2","doi-asserted-by":"crossref","first-page":"5917","DOI":"10.3390\/ijms24065917","article-title":"Hypophysitis: defining histopathologic variants and a review of emerging clinical causative entities","volume":"24","author":"Rawanduzy","year":"2023","journal-title":"Int J Mol Sci"},{"key":"2026081205131348300_luag221-B3","volume-title":"Endotext","author":"Prete"},{"issue":"18","key":"2026081205131348300_luag221-B4","doi-asserted-by":"crossref","first-page":"2025","DOI":"10.2169\/internalmedicine.50.5386","article-title":"Lymphocytic hypophysitis accompanied by aseptic meningitis mimics subacute meningoencephalitis","volume":"50","author":"Suzuki","year":"2011","journal-title":"Internal Medicine"},{"issue":"6","key":"2026081205131348300_luag221-B5","doi-asserted-by":"crossref","DOI":"10.5692\/clinicalneurol.cn-002098","article-title":"A case of lymphocytic hypophysitis initially diagnosed as aseptic meningitis","volume":"65","author":"Miura","year":"2025","journal-title":"Rinsho Shinkeigaku"},{"issue":"7","key":"2026081205131348300_luag221-B6","article-title":"Weight loss improved hypothalamic GH deficiency but not hypogonadotropic hypogonadism in a man with Down syndrome","volume":"2","author":"Nakagawa","year":"2024","journal-title":"JCEM Case Rep"},{"issue":"6","key":"2026081205131348300_luag221-B7","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1089\/thy.2006.0311","article-title":"Do we still need the TRH stimulation test?","volume":"17","author":"Atmaca","year":"2007","journal-title":"Thyroid"},{"issue":"4","key":"2026081205131348300_luag221-B8","first-page":"711","article-title":"Effect of age and sex on circulating and pituitary prolactin levels in human","volume":"83","author":"Yamaji","year":"1976","journal-title":"Acta Endocrinol (Copenh)"},{"issue":"11","key":"2026081205131348300_luag221-B9","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1507\/endocrj.EJ16-0168","article-title":"Relationship of each anterior pituitary hormone deficiency to the size of non-functioning pituitary adenoma in the hospitalized patients","volume":"63","author":"Mukai","year":"2016","journal-title":"Endocr J"},{"issue":"2","key":"2026081205131348300_luag221-B10","doi-asserted-by":"crossref","first-page":"93","DOI":"10.3109\/01485019308987740","article-title":"Hormone profiles and contralateral testicular histology in Down\u2019s syndrome with unilateral testicular tumor","volume":"30","author":"Sasagawa","year":"1993","journal-title":"Arch Androl"},{"issue":"1","key":"2026081205131348300_luag221-B11","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1530\/EJE-07-0066","article-title":"A simple diagnostic test using GH-releasing peptide-2 in adult GH deficiency","volume":"157","author":"Chihara","year":"2007","journal-title":"Eur J Endocrinol"},{"key":"2026081205131348300_luag221-B12","first-page":"1","volume-title":"Procalcitonin - 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