Behçet's Disease Manifesting as Panhypopituitarism Due to a Compressive Aspergillus Granuloma Adjacent to the Pituitary Gland: A Case Report
| Author | Muhanna Kazempour | en |
| Author | Sootiya Yousefi | en |
| Author | Azam Erfanifar | en |
| Author | Minoosh Shabani | en |
| Author | Reza Adabi Firoozjah | en |
| Orcid | Muhanna Kazempour [0000-0002-2507-5223] | en |
| Orcid | Sootiya Yousefi [0009-0000-5845-6666] | en |
| Orcid | Azam Erfanifar [0000-0002-9530-0860] | en |
| Orcid | Minoosh Shabani [0000-0002-4064-8325] | en |
| Orcid | Reza Adabi Firoozjah [0000-0003-2395-4635] | en |
| Issued Date | 2026-04-30 | en |
| Abstract | Introduction: Behçet's disease (BD) is a chronic, relapsing, multisystem inflammatory disorder of unknown etiology, characterized by mucocutaneous, ocular, neurologic, vascular, and gastrointestinal manifestations. Endocrine involvement, particularly hypothalamic-pituitary axis dysfunction, is uncommon and is often associated with neuro-Behçet syndrome or opportunistic infections in immunocompromised patients. Case Presentation: We report a rare case of a 51-year-old man with a 20-year history of BD and poorly controlled type 2 diabetes mellitus who presented with nausea, anorexia, abdominal pain, weight loss, and progressive blurred vision. He had been treated with prednisolone and azathioprine for BD and with insulin for diabetes. Laboratory findings showed hyperglycemia, elevated inflammatory markers, and adrenal insufficiency. Brain imaging revealed a heterogeneous sellar mass measuring 41 × 24 × 37 mm with hemorrhagic components and extension into the sphenoid sinus and nasopharynx, mimicking a pituitary macroadenoma with apoplexy. Transsphenoidal surgery evacuated a fungal granulomatous lesion that was positive for Aspergillus species by polymerase chain reaction and histopathology. Postoperative evaluation confirmed panhypopituitarism, prompting hormone replacement therapy with prednisolone, levothyroxine, and testosterone and antifungal treatment with initial amphotericin B followed by voriconazole. The patient's symptoms improved, inflammatory markers decreased by discharge, and his condition remained stable at the 2-month follow-up. Conclusions: This case highlights the need to consider fungal infections, such as aspergillosis, in the differential diagnosis of sellar masses in patients with BD, diabetes, or iatrogenic immunosuppression. Prompt surgical intervention, antifungal therapy, and endocrine management are critical for optimizing outcomes. | en |
| DOI | https://doi.org/10.5812/archcid-173083 | en |
| URI | https://brieflands.com/journals/archcid/articles/173083 | en |
| Keyword | Behçet's Disease | en |
| Keyword | Panhypopituitarism | en |
| Keyword | Aspergillus Infection | en |
| Keyword | Sellar Mass | en |
| Keyword | Immunosuppression | en |
| Publisher | Brieflands | en |
| Title | Behçet's Disease Manifesting as Panhypopituitarism Due to a Compressive <i>Aspergillus</i> Granuloma Adjacent to the Pituitary Gland: A Case Report | en |
| Type | Case Report | en |
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