Hashimoto K, Takao T, Makino S
Second Department of Internal Medicine, Kochi Medical School, Japan.
Endocr J. 1997 Feb;44(1):1-10. doi: 10.1507/endocrj.44.1.
One hundred and twenty-four cases of lymphocytic adenohypophysitis have been reported since 1962. Nearly 60% of the cases in women involved inset of the disease in relation to pregnancy. Headache and visual field defects were the most frequent symptoms. Most patients showed signs of either isolated or multiple anterior pituitary hormone deficiency. ACTH secretion was impaired the most frequently, followed by TSH, gonadotropins, GH and PRL secretion. One third of the cases involved hyperprolactinemia. Tissue from patients with lymphocytic infundibuloneurohypophysitis, also suffering from DI, revealed lymphocytic inflammation limited to the infundibulum, stalk, and neurohypophysis. Twenty of these 124 lymphocytic adenohypophysitis patients developed DI before treatment, and neuroimaging studies revealed thickening of the pituitary stalk in some. At least in a few cases, chronic lymphocytic infiltration occurred in both the infundibuloneurohypophysitis and adenohypophysis. Although both lymphocytic adenohypophysitis and infundibuloneurohypophysitis may be caused by autoimmune disorders, the antigens involved may differ.
自1962年以来，共报告了124例淋巴细胞性垂体炎。女性患者中近60%的病例发病与妊娠有关。头痛和视野缺损是最常见的症状。大多数患者表现出单一或多种垂体前叶激素缺乏的体征。促肾上腺皮质激素（ACTH）分泌受损最为常见，其次是促甲状腺激素（TSH）、促性腺激素、生长激素（GH）和催乳素（PRL）分泌。三分之一的病例存在高催乳素血症。淋巴细胞性漏斗神经垂体炎患者的组织，同时患有尿崩症（DI），显示淋巴细胞炎症仅限于漏斗、垂体柄和神经垂体。这124例淋巴细胞性垂体炎患者中有20例在治疗前出现尿崩症，神经影像学研究显示部分患者垂体柄增粗。至少在少数病例中，漏斗神经垂体炎和垂体前叶均出现慢性淋巴细胞浸润。虽然淋巴细胞性垂体炎和漏斗神经垂体炎都可能由自身免疫性疾病引起，但涉及的抗原可能不同。
