Gossain V V, Rovner D R
J Reprod Med. 1984 Apr;29(4):284-8.
A 23-year-old woman presented with primary hypothyroidism and inability to lactate following uneventful childbirth. Endocrine evaluation revealed that she had autoimmune hypothyroidism and deficiencies of ACTH and prolactin. Despite partial hypopituitarism, she again conceived spontaneously, had an uneventful pregnancy and delivery but failed to lactate. Radiologic evaluation of the hypophysis, including CAT scan, was normal, and antibodies to anterior pituitary cells were not detected. The etiology of the pituitary insufficiency might have been autoimmune hypophysitis , a recently described entity in which anterior pituitary, along with the other endocrine glands, is destroyed by an autoimmune process. The clinical course suggested that women with pituitary insufficiency, although rare, are able to conceive and carry the pregnancy to term. Our patient illustrates that prolactin insufficiency does not preclude a successful outcome of pregnancy but can result in no lactation.
一名23岁女性在顺产过程顺利后出现原发性甲状腺功能减退且无法泌乳。内分泌评估显示她患有自身免疫性甲状腺功能减退以及促肾上腺皮质激素和催乳素缺乏。尽管存在部分垂体功能减退，她再次自然受孕，孕期和分娩过程顺利，但仍无法泌乳。包括计算机断层扫描（CAT扫描）在内的垂体放射学评估结果正常，且未检测到抗垂体前叶细胞抗体。垂体功能不全的病因可能是自身免疫性垂体炎，这是一种最近描述的疾病，其中垂体前叶以及其他内分泌腺会被自身免疫过程破坏。临床病程表明，垂体功能不全的女性虽然罕见，但能够受孕并足月分娩。我们的患者表明，催乳素缺乏并不妨碍妊娠成功，但会导致无乳。
