Ozawa Y, Shishiba Y
Department of Internal Medicine, Toranomon Hospital, Tokyo, Japan.
Acta Endocrinol (Copenh). 1993 Jun;128(6):493-8. doi: 10.1530/acta.0.1280493.
Lymphocytic hypophysitis usually occurs in the antepartum or postpartum period and recovery of pituitary dysfunction has not been documented in most cases reported previously. We present a 50-year-old woman with lymphocytic hypophysitis who spontaneously recovered from panhypopituitarism over 18 months with the disappearance of an intrasellar mass. Although lymphocytic hypophysitis is thought to be an autoimmune disease, the clinical and pathogenetic significance of circulating antipituitary autoantibodies has not been clarified. Antipituitary antibodies were studied by immunofluorescence in blood samples obtained during the whole clinical course in this particular patient. Antibodies against rat pituitary cytosol were positive during the period of hypopituitarism and became negative when pituitary function recovered. Antibodies reacting with intact prolactin-secreting rat GH3 and corticotropin-secreting mouse AtT-20 cells were also positive during her period of hypopituitarism. They remained positive for several years after the recovery of pituitary function. We conclude that circulating antibodies against rat pituitary cytosol are good markers of pituitary inflammation in this patient. The other point to be emphasized in this case is the simultaneous development of painless thyroiditis and lymphocytic hypophysitis. We have discussed the pathogenic relationship of these two diseases on the basis of similar cases reported previously.
淋巴细胞性垂体炎通常发生在产前或产后时期，并且在先前报道的大多数病例中，垂体功能障碍并未有恢复的记录。我们报告一例50岁患淋巴细胞性垂体炎的女性患者，其全垂体功能减退在18个月内自发恢复，鞍内肿块消失。虽然淋巴细胞性垂体炎被认为是一种自身免疫性疾病，但循环抗垂体自身抗体的临床和发病机制意义尚未阐明。在该特定患者的整个临床过程中采集的血样，通过免疫荧光法研究抗垂体抗体。在垂体功能减退期间，抗大鼠垂体细胞质抗体呈阳性，垂体功能恢复时变为阴性。在她垂体功能减退期间，与完整的分泌催乳素的大鼠GH3细胞和分泌促肾上腺皮质激素的小鼠AtT - 20细胞反应的抗体也呈阳性。垂体功能恢复后，它们持续阳性数年。我们得出结论，在该患者中，循环抗大鼠垂体细胞质抗体是垂体炎症的良好标志物。该病例中另一个需要强调的点是无痛性甲状腺炎和淋巴细胞性垂体炎同时发生。我们根据先前报道的类似病例讨论了这两种疾病的致病关系。
