Nord Jamie M, Shah Paras P, Verma Rashmi
Department of Ophthalmology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York, USA.
Neuroophthalmology. 2022 Dec 15;47(2):110-116. doi: 10.1080/01658107.2022.2146143. eCollection 2023.
Lymphocytic hypophysitis (LH) is a neuroendocrine disorder characterised by autoimmune inflammation of the pituitary gland with resultant pituitary dysfunction. Rarely, the presenting symptom can be diplopia due to irritation of the third, fourth, or sixth cranial nerves secondary to cavernous sinus involvement of the mass or increased intracranial pressure. We describe the case of a healthy, 20-year-old female with a pupillary sparing third nerve palsy, who was subsequently diagnosed with LH after an endoscopic transsphenoidal biopsy of the mass. She was treated with hormone replacement therapy and corticosteroids, resulting in full resolution of symptoms with no recurrence to date. To our knowledge, this is the first report of a third nerve palsy due to definitive biopsy proven LH. Despite its rarity, the unique presentation and favourable evolution of this case should aid clinicians in its timely recognition, appropriate workup, and treatment.
淋巴细胞性垂体炎（LH）是一种神经内分泌疾病，其特征为垂体的自身免疫性炎症并导致垂体功能障碍。极少情况下，由于肿块累及海绵窦或颅内压升高刺激第三、第四或第六脑神经，首发症状可为复视。我们报告一例健康的20岁女性，患有瞳孔保留的动眼神经麻痹，在内镜下经蝶窦对肿块进行活检后，最终被诊断为LH。她接受了激素替代疗法和皮质类固醇治疗，症状完全缓解，至今未复发。据我们所知，这是首例经确诊活检证实为LH导致的动眼神经麻痹报告。尽管该病罕见，但该病例独特的表现和良好的病情发展应有助于临床医生及时识别、进行适当检查及治疗。
