From the Departments of Neurology (C.G.B., C.L., A.S, M.B., M.S.) and Neuroradiology (A.M.), University of Göttingen, Germany.
Neurology. 2013 Nov 5;81(19):e146-7. doi: 10.1212/01.wnl.0000435307.33389.f7.
A 21-year-old man presented with headache, hypotonia, hypothermia, and somnolence, deteriorating to a Glasgow Coma Scale score of 3 within days. Hormonal testing revealed panhypopituitarism. His cerebral MRI showed a gadolinium-enhancing lesion in the pituitary gland with adjacent changes to the hypothalamus, midbrain, and basal ganglia (figures 1 and 2). Therapy with prednisolone resulted in rapid improvement. Ma2 antibodies were found in the patient's serum and CSF. FDG-PET demonstrated a tumor mass in the superior mediastinum and histology revealed a mediastinal seminoma. Ma2 antibody-mediated paraneoplastic disease has to be considered as a rare differential diagnosis in patients presenting with acute panhypopituitarism.(1.)
一位 21 岁男性以头痛、低张力、低体温和嗜睡为表现，数天内恶化至格拉斯哥昏迷评分 3 分。激素检测显示全垂体功能减退。他的脑部 MRI 显示垂体有增强的钆增强病变，伴有下丘脑、中脑和基底节的邻近改变（图 1 和 2）。泼尼松龙治疗后迅速改善。患者血清和 CSF 中发现 Ma2 抗体。FDG-PET 显示上纵隔有肿瘤肿块，组织学显示纵隔精原细胞瘤。Ma2 抗体介导的副肿瘤性疾病必须被认为是急性全垂体功能减退症患者的罕见鉴别诊断。(1.)
