Acute loss of vision during pregnancy due to a suprasellar mass.
A pregnant woman presented with headaches, bilateral decreased visual acuity, and a central scotoma with a superotemporal hemianopic defect in the right eye and a superotemporal hemianopic defect in the left eye, and bilateral temporal optic disk pallor. Neuroimaging revealed an intrasellar mass with suprasellar extension. Biopsy of the lesion revealed lymphocytic hypophysitis (LH). Treatment with steroids produced marked improvement in visual function. The clinical presentation of lymphocytic hypothysitis may mimic pituitary adenoma and the diagnosis should be suspected in any pregnant or postpartum patient with an intrasellar or suprasellar mass.
Kerrison
J B
JB
Johns Hopkins Medical Institution, Wilmer Ophthalmological Institute, Baltimore, Maryland, USA.
Lee
A G
AG
Weinstein
J M
JM
D000208:Acute Disease; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D008279:Magnetic Resonance Imaging; D010900:Pituitary Diseases / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D010911:Pituitary Neoplasms / Q000175:diagnosis; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic; D015175:Prolactinoma / Q000175:diagnosis; D012658:Sella Turcica; D014786:Vision Disorders / Q000209:etiology* / Q000503:physiopathology; D014794:Visual Fields
D000893:Anti-Inflammatory Agents; D003907:Dexamethasone