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[以全垂体功能减退和黄斑周围暗点为表现的IgG4相关性疾病]

[IgG4 related disease presenting as panhypopituitarism and perimacular scotoma].

作者信息

Sosa Gabriela A, Fainstein-Day Patricia, Christiansen Silvia, Ajler Pablo, Yampolsky Claudio

机构信息

Servicio de Endocrinología, Hospital Provincial de Unquillo, Córdoba, Argentina.

Servicio de Endocrinología, Metabolismo y Medicina Nuclear, Hospital Italiano de Buenos Aires. Argentina. E-mail:

出版信息

Medicina (B Aires). 2018;78(3):194-196.

Abstract

IgG4-related disease (IgG4-RD) is a recently described systemic entity of unknown origin. It predominantly affects older men and has distinctive histopathologic features as storiform fibrosis, obliterative phlebitis, dense lymphoplasmacytic infiltrate with immunostaining for IgG4, and it may be associated with elevated serum levels of IgG4. Although any organ can be affected, pituitary gland is rarely involved. We describe the case of a 36-year-old man who presented with headaches, impaired vision, panhypopituitarism with diabetes insipidus and an infiltrative lesion mainly of infundibulum and pituitary. We arrived at diagnosis of IgG4-RD by pituitary biopsy. A successful response to treatment with immunosuppressive doses of corticosteroids was achieved.

摘要

IgG4相关性疾病(IgG4-RD)是一种最近才被描述的病因不明的全身性疾病。它主要影响老年男性,具有独特的组织病理学特征,如席纹状纤维化、闭塞性静脉炎、IgG4免疫染色的致密淋巴浆细胞浸润,并且可能与血清IgG4水平升高有关。尽管任何器官都可能受累,但垂体很少被累及。我们描述了一例36岁男性患者,其表现为头痛、视力障碍、伴有尿崩症的全垂体功能减退以及主要累及漏斗和垂体的浸润性病变。通过垂体活检,我们确诊为IgG4-RD。给予免疫抑制剂量的糖皮质激素治疗后取得了成功疗效。

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