Hyperprolactinemia Secondary to Allergic Fungal Sinusitis Compressing the Pituitary Gland.
Hyperprolactinemia Secondary to Allergic Fungal Sinusitis Compressing the Pituitary Gland.
复制标题
继发于压迫垂体的过敏性真菌性鼻窦炎的高催乳素血症。
DOI：
10.1155/2016/7260707
复制
发表时间：
2016
影响因子：
0.6
通讯作者：
Jang,DavidW
中科院分区：
文献类型：
--
作者：
Chapurin,Nikita;Wang,Cynthia;Steinberg,DavidM;Jang,DavidW
客观的。我们的目的是描述文献中的第一例过敏性真菌性鼻窦炎 (AFS)，由于垂体受压而出现高催乳素血症。病例介绍。一名 37 岁女性因双侧溢乳和枕部头痛数周就诊。检查显示催乳素升高至 94.4，妊娠试验呈阴性，甲状腺功能正常。 MRI 和 CT 显示右侧蝶窦内有一 5.0 × 2.7 × 2.5 cm 的不均匀扩张肿块，没有最初怀疑的垂体腺瘤。患者接受卡麦角林治疗以控制症状，直至最终治疗。结果。患者接受了右侧内窥镜蝶窦切开术，发现蝶窦内有鼻息肉和真菌碎片，与 AFS 一致。蝶鞍和斜坡有骨质侵蚀。病理学和微生物学与弯孢菌属引起的过敏性真菌性鼻窦炎一致。手术后 4 周，催乳素水平恢复正常，症状得到缓解。结论。仅功能性内窥镜鼻窦手术就能够逆转患者的垂体功能障碍。据我们所知，这是首例因垂体受压而表现为高催乳素血症的 AFS 病例。
Objective. We aim to describe the first case in the literature of allergic fungal sinusitis (AFS) presenting with hyperprolactinemia due to compression of the pituitary gland.Case Presentation. A 37‐year‐old female presented with bilateral galactorrhea and occipital headaches of several weeks. Workup revealed elevated prolactin of 94.4, negative pregnancy test, and normal thyroid function. MRI and CT demonstrated a 5.0 × 2.7 × 2.5 cm heterogeneous expansile mass in the right sphenoid sinus with no pituitary adenoma as originally suspected. Patient was placed on cabergoline for symptomatic control until definitive treatment.Results. The patient underwent right endoscopic sphenoidotomy, which revealed nasal polyps and fungal debris in the sphenoid sinus, consistent with AFS. There was bony erosion of the sella and clivus. Pathology and microbiology were consistent with allergic fungal sinusitis caused byCurvulariaspecies. Prolactin levels normalized four weeks after surgery with resolution of symptoms.Conclusion. Functional endoscopic sinus surgery alone was able to reverse the patient’s pituitary dysfunction. To our knowledge, this is the first case of AFS presenting as hyperprolactinemia due to pituitary compression.