Assistance Publique-Hôpitaux de Paris (P.C.), Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction, Centre de Référence des Maladies Rares de l'Hypophyse, 78 rue du Général Leclerc, Le Kremlin-Bicêtre F-94275, France; UMR S-1185, Fac Med Paris-Sud, Université Paris-Saclay, Le Kremlin-Bicêtre F-94276, France.
Endocrinol Metab Clin North Am. 2019 Sep;48(3):583-603. doi: 10.1016/j.ecl.2019.05.005. Epub 2019 Jun 18.
Diagnosis of lymphocytic hypophysitis occurring in the peripartum period is based on clinical and neuroradiological data and does not require a biopsy. Its course is generally spontaneously favorable in terms of mass effect but may require the administration of corticosteroids or even transsphenoidal resection. The course of pituitary deficiencies is highly variable; some cases recover over time, whereas others persist indefinitely. Sheehan syndrome is very rare in developed countries. Because agalactia and amenorrhea are often neglected, the diagnosis is generally delayed. Diabetes insipidus occurring in late pregnancy is caused by the increased placental production of vasopressinase and disappears after delivery.
产褥期淋巴细胞性垂体炎的诊断基于临床和神经影像学数据,并不需要进行活检。从肿块效应来看,其病程通常是自发好转的,但可能需要使用皮质类固醇,甚至经蝶窦切除术进行治疗。垂体功能减退的病程变化很大;有些病例会随时间恢复,而有些则会持续存在。在发达国家,席汉综合征非常罕见。由于哺乳期无乳和闭经经常被忽视,因此通常会延误诊断。妊娠晚期发生的尿崩症是由胎盘产生的血管加压素酶增加引起的,分娩后会消失。