A case of relapsed autoimmune hypothalamitis successfully treated with methylprednisolone and azathioprine.
Autoimmune hypothalamitis is a rare autoimmune neuroendocirne disease. A case of a 70-year-old female with autoimmune hypothalamitis was reported. The chief clinical characteristics were diabetes insipidus and adenopituitary function deficiency. Cranial magnetic resonance imaging (MRI) scan indicated a mass in the hypothalamus. The diagnosis of autoimmune hypothalamitis was presumed. After treatment with prednisone, there was a marked reduction in the mass and the hypothalamus-adenopituitary function partially improved. However, after glucocorticoid therapy was withdrawn, the hypothalamic lesion relapsed progressively. High dose methylprednisolone pulse therapy (HDMPT) in combination with azathioprine was initiated thereafter. During follow-up, MRI scan indicated the lesion shrank strikingly, and the patient's clinical condition improved as well. In view of the good response of the hypothalamic lesion to glucocorticoid and immunodepressant, the putative diagnosis of autoimmune hypothalamitis was confirmed. This case report suggested that HDMPT in combination with azathioprine therapy might be an effective trial for autoimmune hypothalamitis treatment.
Wang
Xian Ling
XL
Department of Endocrinology, Chinese PLA General Hospital, Fuxing Road 28, Beijing, China. wangxianling1972@sohu.com
Lu
Ju Ming
JM
Yang
Li Juan
LJ
Lü
Zhao Hui
ZH
Dou
Jing Tao
JT
Mu
Yi Ming
YM
Pan
Chang Yu
CY
D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001327:Autoimmune Diseases / Q000150:complications / Q000188:drug therapy*; D001379:Azathioprine / Q000627:therapeutic use*; D003919:Diabetes Insipidus / Q000209:etiology / Q000276:immunology / Q000628:therapy; D005260:Female; D006801:Humans; D007027:Hypothalamic Diseases / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008775:Methylprednisolone / Q000627:therapeutic use*; D012008:Recurrence; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D001379:Azathioprine; D008775:Methylprednisolone