Virally-Monod M L, Barrou Z, Basin C, Thomopoulos P, Luton J P
Clinique des Maladies endocriniennes et métaboliques, Hôpital Cochin, Paris.
Presse Med. 1996 Jun 8;25(20):933-8.
Lymphocytic hypophysitis is a rare entity; we report here three cases. This condition usually occurs in women during pregnancy or in the post-partum period. Pituitary enlargement is associated with complete or partial hypopituitarism. The difficulty in diagnosis is well illustrated by our cases and results from the similarity between the clinical and biological signs of adenoma and hypophysitis. Circulating antipituitary antibodies are not constantly found and are nonspecific, evidence only of the autoimmune nature of hypophysitis. Thus the diagnosis has to be undertaken in all suspected cases in pregnant women or during the post-partum period. The clinical course may be very long, emphasizing the need for rigorous long-term observation. The pituitary gland is commonly enlarged and homogenous in lymphocytic hypophysitis, but in our third case the enlargement was heterogeneous with associated cyst formation. We suggest that the inflammatory process could have been maintained by the presence of cysts. Finally, corticosteroids are the therapy of choice in the inflammatory stage and should be undertaken as soon as the diagnosis has been established. Regular surveillance is required.
淋巴细胞性垂体炎是一种罕见疾病；我们在此报告三例病例。这种情况通常发生在孕期或产后的女性身上。垂体增大与完全或部分垂体功能减退相关。我们的病例很好地说明了诊断的困难，这是由腺瘤和垂体炎的临床及生物学体征相似所致。循环抗垂体抗体并非总能检测到，且缺乏特异性，仅证明垂体炎的自身免疫性质。因此，对于所有孕期或产后疑似病例都必须进行诊断。临床病程可能很长，这凸显了长期严格观察的必要性。淋巴细胞性垂体炎中垂体通常增大且呈均匀性，但在我们的第三例病例中，垂体增大呈异质性并伴有囊肿形成。我们认为囊肿的存在可能维持了炎症过程。最后，皮质类固醇是炎症期的首选治疗药物，一旦确诊就应立即使用。需要定期监测。
