title: Pituitary apoplexy as a consequence of lymphocytic adenohypophysitis in a pregnant woman: a case report.
abstract: OBJECTIVE
  A patient with pituitary apoplexy resulting from lymphocytic adenohypophysitis, which caused visual disturbance during pregnancy, is described. This is the first report of such case.
  
  
  METHODS
  A 23-year-old primigravida in her 25th week of gestation experienced headache and bitemporal hemianopsia of sudden onset. Magnetic resonance imaging (MRI) revealed a large pituitary mass with intratumoral hemorrhage. Although conservative treatment with intravenous glycerol improved the symptoms partially, the visual symptoms worsened again 6 weeks later. After delivering a girl by scheduled caesarean section her visual symptoms improved. Despite the symptomatic improvement, MRI showed the chiasmatic compression by the enlarged pituitary gland had not changed. Therefore, trans-sphenoidal surgery to decompress the chiasm was performed. Necrotic tissue was seen exuding behind the enlarged pituitary gland and adenohypophysitis with bleeding (apoplexy) was diagnosed histologically. After follow-up for 40 months, she was doing well without any visual or neurological deficits.
  
  
  CONCLUSIONS
  Although relatively rare, pituitary apoplexy as a consequence of lymphocytic adenohypophysitis should be borne in mind when a pregnant woman presents with headache and visual disturbance of sudden onset.
authors.affiliation: Departments of Neurosurgery, Teikyo University School of Medicine, Kaga, Japan. tfujimak-tky@umin.ac.jp
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Fujimaki
authors.forename: Shinji
authors.initials: S
authors.lastname: Hotta
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Mochizuki
authors.forename: Takuya
authors.initials: T
authors.lastname: Ayabe
authors.forename: Akira
authors.initials: A
authors.lastname: Matsuno
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Takagi
authors.forename: Tadayoshi
authors.initials: T
authors.lastname: Nakagomi
authors.forename: Akira
authors.initials: A
authors.lastname: Tamura
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D010899:Pituitary Apoplexy / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D010900:Pituitary Diseases / Q000150:complications* / Q000473:pathology / Q000601:surgery; D011247:Pregnancy; D037841:Pregnant People; D013194:Staining and Labeling / Q000379:methods