Al-Salihi Mohammed Maan, Rahman Md Moshiur, Al-Jebur Maryam Sabah, Rahman Sabrina, Lozada-Martinez Ivan David, Rahman Raphia, Moscote-Salazar Luis Rafael
Medical Doctor College of Medicine. University of Baghdad, Baghdad, Iraq.
Department of Neurosurgery, Holy Family Red Crescent Medical College, Dhaka, Bangladesh.
Int J Surg Open. 2021 Sep;35:100390. doi: 10.1016/j.ijso.2021.100390. Epub 2021 Aug 25.
Several neuro-ophthalmic manifestations have been reported with coronavirus disease 2019 (COVID-19) infection. However, isolated optic neuritis was infrequently reported in humans with COVID-19. If it occurred, optic neuritis was usually a part of a demyelinating syndrome.
In this paper, we report a case of optic neuritis concomitant with an undiagnosed pituitary macroadenoma discovered during active COVID-19 infection. The case was a 33-year-old woman with infertility who was recently found to have a pituitary macroadenoma secreting prolactin. During active COVID-19 infection, the patient developed optic neuritis that responded well to corticosteroids. Brain imaging and hormonal profile negated the presence of any demyelinating disease or pituitary apoplexy.
A dilemma of whether optic neuritis occurring concomitantly with pituitary macroadenoma is just a coincidence, or there is an association remains unresolved. Whether COVID-19 infection might precipitate optic neuritis in patients with pituitary macroadenoma or not remains an issue to be answered by observing data from future case reports about similar findings.
Optic neuritis in concomitant with pituitary macroadenoma following COVID-19 infection represents a dilemma of whether the visual symptoms are attributed to the tumor or COVID-19 infection.
已有报道称2019冠状病毒病(COVID-19)感染会出现多种神经眼科表现。然而,COVID-19患者中孤立性视神经炎的报道较少。若出现视神经炎,通常是脱髓鞘综合征的一部分。
在本文中,我们报告了一例在COVID-19感染活跃期发现的视神经炎合并未确诊垂体大腺瘤的病例。该病例为一名33岁不孕女性,近期发现患有分泌催乳素的垂体大腺瘤。在COVID-19感染活跃期,患者出现视神经炎,对皮质类固醇治疗反应良好。脑部影像学检查和激素水平分析排除了任何脱髓鞘疾病或垂体卒中的存在。
垂体大腺瘤合并视神经炎是纯属巧合还是存在关联,这一难题仍未解决。COVID-19感染是否会促使垂体大腺瘤患者发生视神经炎,仍有待通过观察未来类似病例报告的数据来解答。
COVID-19感染后垂体大腺瘤合并视神经炎,意味着视觉症状究竟归因于肿瘤还是COVID-19感染这一难题。