Dzeranova L K, Pigarova E A, Vorotnikova S Yu, Voznesenskaya A A
Endocrinology Research Centre.
Probl Endokrinol (Mosk). 2024 Sep 15;70(4):15-23. doi: 10.14341/probl13384.
Autoimmune/lymphocytic hypophysitis is one of the rare causes of central diabetes insipidus in adults and is most common among women in the second or third trimester of pregnancy. Numerous studies have shown that lymphocytic hypophysitis is characterized by a very variable clinical signs with the development of neurological symptoms, visual disturbances and hypopituitarism with partial or complete loss of pituitary function, as well as a number of features in magnetic resonance imaging (MRI). Isolated lymphocytic indibuloneurohypophysitis occurs in fewer cases and involves the posterior lobe and stalk of the pituitary gland with a clinical presentation of diabetes insipidus. The above clinical case describes the development of hypophysitis in a pregnant woman with a predominant lesion of the posterior pituitary gland and an outcome in diabetes insipidus, which persists 6 years after pregnancy and childbirth. In the article some aspects of the differential diagnosis of diabetes insipidus in pregnant women, as well as instrumental diagnosis and treatment approaches of hypophysitis are discussed.
自身免疫性/淋巴细胞性垂体炎是成人中枢性尿崩症的罕见病因之一，在妊娠中期或晚期的女性中最为常见。大量研究表明，淋巴细胞性垂体炎的临床体征变化很大，会出现神经症状、视觉障碍以及垂体功能部分或完全丧失导致的垂体功能减退，磁共振成像（MRI）也有一些特征表现。孤立性淋巴细胞性神经垂体炎病例较少，累及垂体后叶和柄，临床表现为尿崩症。上述临床病例描述了一名孕妇垂体炎的发展情况，主要病变位于垂体后叶，结果发展为尿崩症，在妊娠和分娩后6年仍持续存在。本文讨论了孕妇尿崩症鉴别诊断的一些方面，以及垂体炎的器械诊断和治疗方法。
