Pituitary dysfunction associated with tuberculous meningitis

Authors

  • Matheus Costa Freitas Instituto de Infectologia Emilio Ribas, São Paulo, SP, Brasil
  • Josias Oliveira Aragão Instituto de Infectologia Emilio Ribas, São Paulo, SP, Brasil
  • Amanda de Oliveira Rasseli Instituto de Infectologia Emilio Ribas, São Paulo, SP, Brasil
  • Felipe Meirelles Doria Instituto de Infectologia Emilio Ribas, São Paulo, SP, Brasil
  • Bernardo Vicari do Valle Instituto de Infectologia Emilio Ribas, São Paulo, SP, Brasil
  • Isabela Della Torre Oliveira Instituto de Infectologia Emilio Ribas, São Paulo, SP, Brasil

DOI:

https://doi.org/10.5935/2764-734X.e20250462

Keywords:

Tuberculosis, Endocrine, Tuberculosis,, Central Nervous System, Hypophysitis, Case report

Abstract

Tuberculosis can lead to endocrine/metabolic changes in different glands, with varying clinical presentations and forms, while the incidence of pituitary involvement is unknown. We present the case of a patient with a recent diagnosis of AIDS who, upon presenting with tuberculous meningitis, developed diabetes insipidus, hypogonadotropic hypogonadism, and hyperprolactinemia. The diagnosis of hypophysitis was established, but there was no full recovery of hormonal function even after specific treatment.

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References

1. Vinnard C, Blumberg EA. Endocrine and Metabolic Aspects of Tuberculosis. Microbiol Spectr. 2017 Jan;5(1):10.1128/microbiolspec.tnmi7-0035-2016. DOI: 10.1128/microbiolspec.tnmi7-0035-2016

2. Beatrice AM, Selvan C, Mukhopadhyay S. Pituitary dysfunction in infective brain diseases. Indian J Endocrinol Metab. 2013 Dec;17(Suppl 3):S608-11. DOI: 10.4103/2230-8210.123546

3. Lam KS, Sham MM, Tam SC, Ng MM, Ma HT. Hypopituitarism after tuberculous meningitis in childhood. Ann Intern Med. 1993 May 1;118(9):701-6. DOI: 10.7326/0003-4819-118-9-199305010-00007

4. Dhanwal DK, Vyas A, Sharma A, Saxena A. Hypothalamic pituitary abnormalities in tubercular meningitis at the time of diagnosis. Pituitary. 2010 Dec;13(4):304-10. DOI: 10.1007/s11102-010-0234-7

5. Ranjan A, Chandy MJ. Intrasellar tuberculoma. Br J Neurosurg. 1994;8(2):179-85. DOI: 10.3109/02688699409027964

6. Cherian A, Ajitha KC, Iype T, Divya KP. Neurotuberculosis: an update. Acta Neurol Belg. 2021 Feb;121(1):11-21. DOI: 10.1007/s13760-020-01575-0

7. Correia-Neves M, Fröberg G, Korshun L, Viegas S, Vaz P, Ramanlal N, et al. Biomarkers for tuberculosis: the case for lipoarabinomannan. Biomarkers for tuberculosis: the case for lipoarabinomannan. ERJ Open Res. 2019 Feb 11;5(1):00115-2018. DOI: 10.1183/23120541.00115-2018

8. Schaller MA, Wicke F, Foerch C, Weidauer S. Central Nervous System Tuberculosis: Etiology, Clinical Manifestations and Neuroradiological Features. Clin Neuroradiol. 2019 Mar;29(1):3-18. DOI: 10.1007/s00062-018-0726-9

9. Siddiqi OK, Birbeck GL, Ghebremichael M, Mubanga E, Love S, Buback C, et al. Prospective Cohort Study on Performance of Cerebrospinal Fluid (CSF) Xpert MTB/RIF, CSF Lipoarabinomannan (LAM) Lateral Flow Assay (LFA), and Urine LAM LFA for Diagnosis of Tuberculous Meningitis in Zambia. J Clin Microbiol. 2019 Jul 26;57(8):e00652-19. DOI: 10.1128/JCM.00652-19

10. Sulaiman T, Medi S, Erdem H, Senbayrak S, Ozturk-Engin D, Inan A, et al. The diagnostic utility of the “Thwaites’ system” and “lancet consensus scoring system” in tuberculous vs. non-tuberculous subacute and chronic meningitis: multicenter analysis of 395 adult patients. BMC Infect Dis. 2020 Oct 23;20(1):788. DOI: 10.1186/s12879-020-05502-9

11. Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Vigilância das Doenças Transmissíveis. Manual de recomendações para o controle da tuberculose no Brasil. 2a ed. Brasília: Ministério da Saúde; 2019 [acesso 2025 fev 20]. Disponível em: https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/svsa/tuberculose/manual-de-recomendacoes-e-controle-da-tuberculose-no-brasil-2a-ed.pdf/view

12. Brasil. Ministério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Complexo da Saúde. Secretaria de Vigilância em Saúde e Ambiente. Protocolo Clínico e Diretrizes Terapêuticas para Manejo da Infecção pelo HIV em Adultos: Módulo 2: Coinfecções e Infecções Oportunistas [recurso eletrônico]. Brasília: Ministério da Saúde; 2023 [acesso 2025 fev 20]. Disponível em: https://www.gov.br/aids/pt-br/central-de-conteudo/pcdts/PCDT_HIV_Modulo_2_2024_eletrnicoISBN.pdf

13. Delsedime M, Aguggia M, Cantello R, Chiado Cutin I, Nicola G, Torta R, et al. Isolated hypophyseal tuberculoma: case report. Clin Neuropathol. 1988 Nov/Dec;7(6):311-3.

14. Srisukh S, Tanpaibule T, Kiertiburanakul S, Boongird A, Wattanatranon D, Panyaping T, et al. Pituitary tuberculoma: A consideration in the differential diagnosis in a patient manifesting with pituitary apoplexy-like syndrome. IDCases. 2016 Jul 29;5:63-6. DOI: 10.1016/j.idcr.2016.07.012

15. Tanimoto K, Imbe A, Shishikura K, Imbe H, Hiraiwa T, Miyata T, et al. Reversible hypopituitarism with pituitary tuberculoma. Intern Med. 2015;54(10):1247-51. DOI: 10.2169/internalmedicine.54.3435

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Published

2025-05-30

How to Cite

1.
Freitas MC, Aragão JO, Rasseli A de O, Doria FM, Valle BV do, Oliveira IDT. Pituitary dysfunction associated with tuberculous meningitis. IeE [Internet]. 2025 May 30 [cited 2026 Mar. 15];4:e20250462. Available from: https://infectionsinevidence.org/index.php/journal/article/view/46

Issue

Vol. 4 (2025)

Section

Case Reports

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