Kristof R A, Van Roost D, Klingmüller D, Springer W, Schramm J
Department of Neurosurgery, University of Bonn, Germany.
J Neurol Neurosurg Psychiatry. 1999 Sep;67(3):398-402. doi: 10.1136/jnnp.67.3.398.
Criteria for the non-invasive diagnosis of lymphocytic hypophysitis (LyHy) and the results of the first prospective trial of high dose methylprednisolone pulse therapy (HDMPT) in nine patients are presented. In three patients, the diagnosis was established histologically, and in the others by clinical and endocrinological assessment, MRI, CSF examination, and measurement of thyroglobulin autoantibody concentration. After HDMPT, adenopituitary function improved in four of the nine patients and diabetes insipidus ceased or improved in all four concerned patients. The MRI findings improved in seven patients. LyHy has to be considered in the differential diagnosis of sellar lesions. The presumptive non-invasive diagnosis of LyHy seems possible in a high proportion of patients. HDMPT may result in the improvement of clinical, endocrinological, and MRI findings.
本文介绍了淋巴细胞性垂体炎（LyHy）的无创诊断标准以及9例患者接受高剂量甲基强的松龙脉冲疗法（HDMPT）的首个前瞻性试验结果。3例患者经组织学确诊，其他患者通过临床和内分泌评估、MRI、脑脊液检查以及甲状腺球蛋白自身抗体浓度测定确诊。HDMPT治疗后，9例患者中有4例腺垂体功能改善，4例相关患者的尿崩症停止或改善。7例患者的MRI表现改善。在鞍区病变的鉴别诊断中必须考虑LyHy。在大部分患者中似乎可以进行LyHy的推定无创诊断。HDMPT可能会改善临床、内分泌和MRI表现。
