Changes of hormone levels in patient with lymphocytic hypophysitis before and after treatment: A case report and literature review / 吉林大学学报(医学版)

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.