Coeliac disease and lymphocytic hypophysitis

摘要

Ami Schattner and Taiba Zornitzki describe a man with anaemia, arthralgia, and gastrointestinal involvement (June 30, p 2214) Many ancillary tests were done, resulting in an eventual diagnosis of corticotropin deficiency possibly caused by lymphocytic hypophysitis. One test that was not done was for coeliac disease. This disease is very common and has protean manifestations matching most findings in Schattner and Zornitzki's patient. Steroids are also used in its treatment, and the patient's recovery might therefore be due to their effect on coeliac disease, which can occur with lymphocytic hypophysitis. Finally, as well as heeding Occam's razor, "When you hear hoofbeats, don't think zebras" should also be kept in mind