吉林大学学报(医学版) ›› 2019, Vol. 45 ›› Issue (02): 426-429.doi: 10.13481/j.1671-587x.20190238

• 临床医学 • 上一篇    

淋巴细胞性垂体炎患者治疗前后激素水平变化1例报告及文献复习

王淑敏, 张雪姣, 王桂侠, 王欢, 高影, 谢晓娜   

  1. 吉林大学第一医院内分泌代谢科, 吉林 长春 130021
  • 收稿日期:2018-09-06 发布日期:2019-03-29
  • 通讯作者: 高影,教授,硕士研究生导师(Tel:0431-88782557,E-mail:gaoyingcc@sina.com);谢晓娜,副教授(Tel:0431-88782557,E-mail:xiexn@jlu.edu.cn) E-mail:gaoyingcc@sina.com;xiexn@jlu.edu.cn
  • 作者简介:王淑敏(1991-),女,山东省潍坊市人,在读医学硕士,主要从事糖尿病及其并发症诊治方面的研究。
  • 基金资助:
    吉林省财政厅科研基金资助课题(20170101-1)

Changes of hormone levels in patient with lymphocytic hypophysitis before and after treatment: A case report and literature review

WANG Shumin, ZHANG Xuejiao, WANG Guixia, WANG Huan, GAO Ying, XIE Xiaona   

  1. Department of Endocrinology and Metabolism, First Hospital, Jilin University, Changchun 130021, China
  • Received:2018-09-06 Published:2019-03-29

摘要: 目的:探讨淋巴细胞性垂体炎(LYH)的临床表现和影像学特点及治疗原则,阐述明确诊断及激素治疗的重要性。方法:收集1例经手术病理诊断为LYH患者的临床资料,结合国内外相关文献,分析其临床表现、影像学特点及治疗方法。结果:患者,女性,28岁,因间断性头痛2个月就诊。查体未见明显阳性体征,头MRI提示垂体占位性病变,行甲状腺彩超、垂体-甲状腺轴激素、垂体-肾上腺轴激素、垂体-性腺轴激素和戈那瑞林实验等相关检查。结合患者的临床表现、影像学检查和实验室检查结果初步考虑垂体腺瘤的可能性大,行鞍区占位性病变切除术,术后病理提示LYH。患者术后头痛症状明显好转,但仍有腺垂体功能低下,给予激素替代治疗。3个月后,患者性激素水平正常,恢复正常月经,仍有间断头痛,甲状腺功能减低。结论:LYH与垂体腺瘤很难鉴别。病理活检是LYH的诊断金标准。LYH患者手术治疗后仍可能存在腺垂体功能低下,需长期激素替代治疗。

关键词: 淋巴细胞性垂体炎, 垂体功能减退症, 头痛, 垂体腺瘤

Abstract: Objective: To investigate the clinical characteristics,imaging features and therapy of lymphocytic hypophysitis(LYH),and to clarify the importance of definitive diagnosis and hormonal therapy.Methods: The clinical materials of a LYH patient diagnosed by the post-operative pathology were collected;combined with the relative literatures,the clinical performance,imageological features and diagnosis and treatment methods were analyzed.Results: The patient was a 28 years old woman with intermittent headache for 2 months and went to hospital.There was no abnormal signs on physical examination.The cephalic MRI results showed the pituitary space-occupying lesions.Relevant examinations including thyroid color Dopplar ultrasound,pituitary thyroid hormone,Gonarelin test and so on were performed.The clinical manifestations, imaging examinations and laboratory examinations suggested pituitary adenomas.The patient underwent transsphenoidal saddle area surgery.The post-operative pathology suggested LYH.After operation, the headache symptom was improved obviously, but the hypopituitarism presented, and the patient was given hormone replacement therapy.It took 3 months for the patient to recover the normal levels of sexual hormones and menstruation.But intermittent headache and hypothyroidism still prestented.Conclusion: It is difficult to distinguish LYH from pituitary adenoma.Pathological biopsy is the gold standard for the diagnosis of LYH.Hypopituitarism may exist after surgical treatment, and long-term hormone replacement therapy should be initiated as needed.

Key words: lymphocytic hypophysitis, hypopituitarism, headache, pituitary adenoma

中图分类号: 

  • R593.2