Paja M, Estrada J, Ojeda A, Ramón y Cajal S, García-Uría J, Lucas T
Department of Endocrinology, Clínica Puerta de Hierro, Madrid, Spain.
Postgrad Med J. 1994 Mar;70(821):220-4. doi: 10.1136/pgmj.70.821.220.
A 25 year old non-pregnant woman presented with a one-year history of amenorrhoea and polyuria. Three months before her admission, she had suffered lymphocytic meningitis. Hormonal studies revealed hypopituitarism and central diabetes insipidus, with associated primary autoimmune hypothyroidism. Computed tomographic scan and magnetic resonance imaging showed a pituitary mass with suprasellar extension and thickened stalk. Transsphenoidal surgery was performed and the histological study revealed fibrosis and diffuse lymphocytic infiltration with predominance of CD4 lymphocytes. This further case of lymphocytic hypophysitis was not related to pregnancy and produced diabetes insipidus, two uncommon associations. We discuss the features that can lead to a preoperative suspicion of this rare disorder.
一名25岁未孕女性出现闭经和多尿症状1年。入院前3个月，她曾患淋巴细胞性脑膜炎。激素检查显示垂体功能减退和中枢性尿崩症，并伴有原发性自身免疫性甲状腺功能减退。计算机断层扫描和磁共振成像显示垂体肿块伴鞍上延伸及垂体柄增粗。行经蝶窦手术，组织学检查显示纤维化和弥漫性淋巴细胞浸润，以CD4淋巴细胞为主。这例淋巴细胞性垂体炎与妊娠无关，且导致了尿崩症，这两种关联并不常见。我们讨论了可导致术前怀疑这种罕见疾病的特征。
