Sonnet E, Roudaut N, Mériot P, Besson G, Kerlan V
Service of Endocrinology, CHU Brest, 29609 Brest, France.
J Endocrinol Invest. 2006 Apr;29(4):353-7. doi: 10.1007/BF03344108.
We report the case of a 29-yr-old woman who first presented an aseptic meningitis at the beginning of a pregnancy. She was admitted one month later with headaches and vomiting. Panhypopituitarism with diabetes insipidus was diagnosed. Magnetic resonance imaging (MRI) data suggested the existence of lymphocytic infundibulohypophysitis, with inflammation of the suprasellar area. No new symptoms were noticed until 6 months later when this patient pointed out troubles of the visual field, due to a compression of the optic chiasma. Three boluses of 1 g methylprednisolone were prescribed, with no effects. After delivery, the defects of the visual field increased. A neurosurgical intervention was decided. Diagnosis of Rathke's cleft cyst (RCC) was made. We concluded that this patient presented a rupture of a RCC, which occurred at the beginning of pregnancy, associated later with panhypopituitarism with diabetes insipidus, due to a probable hypophysitis. The end of the pregnancy was marked by consequences of an increased volume of the RCC. To our knowledge, this case is the first described during pregnancy.
我们报告了一例29岁女性病例，该患者在妊娠初期首次出现无菌性脑膜炎。一个月后因头痛和呕吐入院。诊断为全垂体功能减退伴尿崩症。磁共振成像（MRI）数据提示存在淋巴细胞性漏斗部垂体炎，视交叉上区有炎症。直到6个月后，该患者指出由于视交叉受压出现视野问题，此前未发现新症状。给予三次1 g甲泼尼龙冲击治疗，无效。产后视野缺损加重。决定进行神经外科干预。诊断为拉克氏囊肿（RCC）破裂。我们得出结论，该患者在妊娠初期出现RCC破裂，随后因可能的垂体炎并发全垂体功能减退伴尿崩症。妊娠末期以RCC体积增大的后果为特征。据我们所知，该病例是首次在孕期描述的此类病例。
