Koide Hisashi, Shiga Akina, Komai Eri, Yamato Azusa, Fujimoto Masanori, Tamura Ai, Kono Takashi, Nakayama Akitoshi, Takiguchi Tomoko, Higuchi Seiichiro, Sakuma Ikki, Nagano Hidekazu, Hashimoto Naoko, Suzuki Sawako, Takeda Yasuaki, Shibuya Makoto, Nishioka Hiroshi, Yamada Shozo, Inoshita Naoko, Ishiwatari Norio, Horiguchi Kentaro, Yokote Koutaro, Tanaka Tomoaki
Department of Medicine, Division of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Japan.
Clinical Cell Biology and Medicine, Chiba University Graduate School of Medicine, Japan.
Intern Med. 2018 Feb 1;57(3):367-375. doi: 10.2169/internalmedicine.8446-16. Epub 2017 Nov 1.
We herein report the case of a 25-year-old woman who presented with severe headache and visual field defects after childbirth. Magnetic resonance imaging revealed marked swelling of the pituitary gland, and an endocrinological examination revealed panhypopituitarism and diabetes insipidus. An immunohistological analysis of a transsphenoidal biopsy sample of the pituitary gland showed the significant accumulation of an immunogloblin G4 (IgG4)-positive population, leading to the diagnosis of IgG4-related hypophysitis. The patient was treated with prednisolone, which markedly reduced the swelling of the pituitary gland, in association with recovery of the pituitary function. This is a rare case of biopsy-proven IgG4-related hypophysitis with a postpartum onset.
我们在此报告一例25岁女性病例,该患者产后出现严重头痛和视野缺损。磁共振成像显示垂体明显肿胀,内分泌检查显示全垂体功能减退和尿崩症。垂体经蝶窦活检样本的免疫组织学分析显示免疫球蛋白G4(IgG4)阳性细胞显著聚集,从而诊断为IgG4相关性垂体炎。患者接受泼尼松龙治疗,垂体肿胀明显减轻,垂体功能恢复。这是一例罕见的经活检证实的产后起病的IgG4相关性垂体炎病例。