Vittaz Laurence, Ramanoelina Jacky, Mahr Alfred, Cohen Régis, Cohen Pascal, Reach Gérard, Guillevin Loïc
Service de médecine interne et d'endocrinologie, Hôpital Avicenne, Bobigny.
Presse Med. 2004 Dec 18;33(22):1585-90. doi: 10.1016/s0755-4982(04)98998-1.
Wegener's granulomatosis is a necrotizing vasculitis, usually localised in the upper respiratory track, lungs and kidneys. Less than 20 cases of pituitary involvement have been published, and many of them localized to anterior pituitary lesions, revealed by diabetes insipidus.
We report two cases of Wegener's granulomatosis, with anterior pituitary manifestations: the first patient exhibited diabetes insipidus, with secondary revelation of panhypopituitarism. In the second, the anterior pituitary involvement was manifested in the form of amenorrhoea and galactorrhoea. The outcomes followed the course of the systemic disease.
Endocrine manifestations can easily be occulted by the general symptoms of Wegener's granulomatosis, and systematic screening should be applied in cases of pituitary involvement.
韦格纳肉芽肿是一种坏死性血管炎,通常累及上呼吸道、肺和肾脏。垂体受累的病例报道不足20例,其中许多局限于垂体前叶病变,表现为尿崩症。
我们报告两例韦格纳肉芽肿伴有垂体前叶表现的病例:首例患者表现为尿崩症,继发全垂体功能减退。第二例患者垂体前叶受累表现为闭经和溢乳。其结局与系统性疾病的病程相关。
韦格纳肉芽肿的全身症状容易掩盖内分泌表现,对于垂体受累的病例应进行系统筛查。