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Titolo:
SPONTANEOUSLY RESOLVING LYMPHOCYTIC HYPOPHYSITIS AS A CAUSE OF POSTPARTUM DIABETES-INSIPIDUS
Autore:
OBER KP; ELSTER A;
Indirizzi:
WAKE FOREST UNIV,BOWMAN GRAY SCH MED,ENDOCRINOL & METABOL SECT WINSTON SALEM NC 27157
Titolo Testata:
The Endocrinologist
fascicolo: 2, volume: 4, anno: 1994,
pagine: 107 - 111
SICI:
1051-2144(1994)4:2<107:SRLHAA>2.0.ZU;2-8
Fonte:
ISI
Lingua:
ENG
Soggetto:
PITUITARY MASS; SPONTANEOUS REGRESSION; ADENOHYPOPHYSITIS; PREGNANCY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
17
Recensione:
Indirizzi per estratti:
Citazione:
K.P. Ober e A. Elster, "SPONTANEOUSLY RESOLVING LYMPHOCYTIC HYPOPHYSITIS AS A CAUSE OF POSTPARTUM DIABETES-INSIPIDUS", The Endocrinologist, 4(2), 1994, pp. 107-111

Abstract

A previously healthy 34-year-old woman developed diabetes insipidus 5months after an uncomplicated pregnancy and delivery. MRI showed marked thickening of the pituitary stalk and prominence of the median eminence of the hypothalamus, with a somewhat small anterior pituitary gland. Further endocrine testing documented mild hyperprolactinemia and evidence of Hashimoto's disease (elevated TSH and an elevated titer of antimicrosomal antibodies). The radiographic abnormalities resolved spontaneously over the next 3 months, leaving a partially empty sella turcica. The prolactin level also normalized, but diabetes insipidus persisted. Although the diagnosis was not biopsy-proven, this case has a number of features that are typical of lymphocytic hypophysitis (whichare discussed); however, unlike the typical presentation of lymphocytic hypophysitis (in which anterior pituitary involvement is prominent,usually as a pituitary mass with anterior pituitary hypofunction), this case is unusual in its presentation with diabetes insipidus and in the localization of radiographic abnormalities to die pituitary stalk and hypothalamus. These features expand and further define die spectrum of the clinical presentation of lymphocytic hypophysitis. This patient's course confirms the recent observations of others that the natural history of this disorder may be that of a self-limiting disease withspontaneous resolution. As a result, the risks associated with confirmation of the diagnosis by biopsy (or surgical resection of involved tissue) are unnecessary and inappropriate if the clinical presentation is consistent with lymphocytic hypophysitis, and if subsequent follow-up demonstrates the anticipated radiographic normalization (as seen here and in other cases). Empty sella syndrome may represent the end stage of lymphocytic hypophysitis in some patients.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/11/20 alle ore 06:26:48