Oda Y, Kamijyo Y, Kang Y
No Shinkei Geka. 1986 Aug;14(9):1155-9.
Lymphoid adenohypophysitis is an autoimmune disorder. Eighteen percent of the multipartums are reported to have autoantibodies to pituitary tissues. The symptoms in lymphoid adenohypophysitis, such as hypopituitarism and sellar tumors, exhibit spontaneous remission. The pituitary is a feasible target organ in other autoimmune diseases of the endocrine system. Of these patients, 19/287 showed a positive immune reaction with pituitary tissue antigens. Our three female patients with sellar and suprasellar mass were clinically diagnosed as having lymphoid adenohypophysitis, because of the spontaneous regression of tumors, or presence of immunologically and endocrinologically abnormal findings. The first case was a 31-year-old woman who had amenorrhea and galactorrhea syndrome for two years after delivery of her second child. CT scan revealed a supraseller enhanced mass lesion. She had concomitant signs of recurrent meningeal irritations. The number of cells in the CSF increased, though the protein concentration increased only slightly. During a one-year close observation, the suprasellar mass spontaneously regressed. The second patient was a 66-year-old woman. In 1945, she underwent hysterectomy and oophorectomy for appendicitis followed by adnexitis. She was admitted because of episodes of headache, vomiting and visual field defect in 1983. CT scan also showed a contrast enhanced mass in the suprasellar region. She had two episodes of high fever. After the treatment with antibiotics and anti-inflammatory agents for 4 months, the tumor disappeared. The third case was a 20-year-old female. She had neither neurological nor endocrinological abnormality, except for attacks of vertigo, nausea and vomiting.(ABSTRACT TRUNCATED AT 250 WORDS)
淋巴细胞性垂体前叶炎是一种自身免疫性疾病。据报道,18%的经产妇体内存在针对垂体组织的自身抗体。淋巴细胞性垂体前叶炎的症状,如垂体功能减退和鞍区肿瘤,可自发缓解。在其他内分泌系统自身免疫性疾病中,垂体是一个可能的靶器官。在这些患者中,287例中有19例对垂体组织抗原呈阳性免疫反应。我们的3例患有鞍区和鞍上肿块的女性患者,由于肿瘤自发消退,或存在免疫和内分泌异常表现,临床诊断为淋巴细胞性垂体前叶炎。第一例是一名31岁女性,在第二次分娩后两年出现闭经和溢乳综合征。CT扫描显示鞍上有一强化肿块病变。她伴有复发性脑膜刺激征。脑脊液中的细胞数量增加,尽管蛋白质浓度仅略有增加。在一年的密切观察期间,鞍上肿块自发消退。第二例患者是一名66岁女性。1945年,她因阑尾炎伴附件炎接受了子宫切除术和卵巢切除术。1983年因头痛、呕吐和视野缺损发作入院。CT扫描也显示鞍上区域有一强化肿块。她有两次高热发作。在用抗生素和抗炎药治疗4个月后,肿瘤消失。第三例是一名20岁女性。除了眩晕、恶心和呕吐发作外,她没有神经或内分泌异常。(摘要截短于250字)