Koshiyama H, Sato H, Yorita S, Koh T, Kanatsuna T, Nishimura K, Hayakawa K, Takahashi J, Hashimoto N
Division of Endocrinology, Kyoto City Hospital, Japan.
Endocr J. 1994 Feb;41(1):93-7. doi: 10.1507/endocrj.41.93.
Lymphocytic adenohypophysitis is an autoimmune disorder of the anterior pituitary gland which usually occurs in a women in the postpartum period. It has been considered that lymphocytic hypophysitis is confined to the adenohypophysis sparing the neurohypophysis, and that diabetes insipidus is not a clinical feature of the disorder. Here we report the case of a 50-year-old woman with lymphocytic hypophysitis which presented with diabetes insipidus. MRI indicated homogeneous swelling of the whole pituitary gland, loss of the normal high intensity of the posterior pituitary, and thickening of the pituitary stalk. A biopsied specimen of the pituitary revealed diffuse lymphocytic infiltration. The diabetes insipidus was controlled by the administration of DDAVP. The anterior pituitary function was not greatly damaged, and no hormonal replacement therapy was necessary. We suggest that this case represents a variant of lymphocytic adenohypophysitis and/or lymphocytic infundibuloneurohypophysitis, in which the chronic inflammatory process involves the infundibulum, adenohypophysis and neurohypophysis.
淋巴细胞性垂体前叶炎是一种垂体前叶的自身免疫性疾病，通常发生于产后女性。一直以来，人们认为淋巴细胞性垂体炎局限于垂体前叶，不累及神经垂体，且尿崩症并非该疾病的临床特征。在此，我们报告一例50岁患有淋巴细胞性垂体炎并伴有尿崩症的女性病例。磁共振成像（MRI）显示整个垂体均匀肿胀，垂体后叶正常高信号消失，垂体柄增粗。垂体活检标本显示弥漫性淋巴细胞浸润。尿崩症通过给予去氨加压素（DDAVP）得到控制。垂体前叶功能未受到严重损害，无需激素替代治疗。我们认为该病例代表了淋巴细胞性垂体前叶炎和/或淋巴细胞性漏斗神经垂体炎的一种变异型，其中慢性炎症过程累及漏斗部、垂体前叶和神经垂体。
