A Case of Bullous Pemphigoid with Hypothyroidism Caused by Hypopituitarism
Authors
Ichiro Kurokawa1, Yutaka Takaya2 and Ayako Kakuno3 1Department of Dermatology; 2Department of General Internal Medicine; 3Department of Pathology, Meiwa Hospital, 4-31, Agenaruo-cho, Nishinomiya, Hyogo 663-8186, Japan
A case of bullous pemphigoid with hypothyroidism caused by hypopituitarism is reported. The patient had a history of brain infarction six years ago. Over three months, tense vesico-bullous eruptions developed on her whole body. Histopathology revealed subepidermal blisters with dense eosinophil infilitrations. A direct immunofluorescent study found deposition of IgG and C3c components in the basement membrane zone. A blood examination showed greatly elevated titer of BP 180 antibody. Based on clinical, histopathological and laboratory findings, the patient was diagnosed as bullous pemphigoid. In our examination of endocrine functions, reduced levels of ACTH, TSH, FT3, FT4 and aldosterone were found, suggesting hypothyroidism caused by hypopituitarism. After the patient was treated by corticosteroid pulse therapy (methylpredonisolone 500mg/d with tapering), the lesions improved. Neurological examination showed lacuna infarction in the brain. We reported a case with bullous pemphigoid with hypothyrodism caused by hypopituitarism.
