PREOPERATIVE DIAGNOSIS OF LYMPHOCYTIC HYPOPHYSITIS (ADENOHYPOPHYSITIS) UNRESPONSIVE TO SHORT COURSE DEXAMETHASONE - CASE-REPORT
PREOPERATIVE DIAGNOSIS OF LYMPHOCYTIC HYPOPHYSITIS (ADENOHYPOPHYSITIS) UNRESPONSIVE TO SHORT COURSE DEXAMETHASONE - CASE-REPORT
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DOI：
10.1227/00006123-199202000-00023
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发表时间：
1992-02-01
期刊：
影响因子：
4.8
通讯作者：
GUTIERREZHARTMANN, A
中科院分区：
文献类型：
--
作者：
REUSCH, JEB;KLEINSCHMIDTDEMASTERS, BK;GUTIERREZHARTMANN, A
淋巴细胞性垂体炎（腺垂体炎）是一种罕见的淋巴细胞浸润的垂体，通常发生在怀孕期间。由于其罕见性，很少在术前被诊断，迄今为止也没有关于治疗的报道。我们描述一个29岁的妇女与垂体质量和视野缺陷，在怀孕期间。患者的垂体轮廓显示甲状腺轴异常和相对较低的催乳素为她的怀孕阶段。这一发现提示腺垂体炎，患者接受了地塞米松试验疗程。然而，视野缺损的进展表明类固醇在剂量和持续时间上都无效。因此，患者接受了部分垂体切除术以减压。病理报告证实为腺垂体炎，在妊娠的剩余时间内继续使用类固醇，视野缺损缓慢恢复正常。本报告是第一例腺垂体炎，术前怀疑诊断，并给予类固醇试验过程。类固醇的剂量和持续时间是无效的。需要进一步评估类固醇在这种疾病中的应用。
Lymphocytic hypophysitis (adenohypophysitis) is a rare lymphocytic infiltration of the pituitary gland that usually occurs during pregnancy. Because of its rarity, it has seldom been diagnosed preoperatively, and no trials of therapeutic treatment have been reported to date. We describe a 29-year-old woman with a pituitary mass and visual-field defects during pregnancy. The patient's pituitary profile revealed an abnormal thyroid axis and relatively low prolactin for her stage of pregnancy. This finding suggested adenohypophysitis, and the patient was given a trial course of dexamethasone. The progression of the visual-field defects, however, indicated that the steroids, both in dosage and duration, were not effective. Thus, the patient underwent a partial hypophysectomy for decompression. The pathology report confirmed adenohyprphysitis, and steroids were continued for the remainder of the pregnancy, with slow resolution of the visual-field defects to normal. This report is the first case of adenohypophysitis where the diagnosis was suspected preoperatively, and a trial course of steroids was given. The steroids at the dosage and duration used were not effective. Further evaluation of the use of steroids in this disease is warranted.