[Spontaneous pregnancy in a patient with lymphocytic hypophysitis].
Lymphocytic hypophysitis(LH) is a rare but increasingly recognized autoimmune endocrine condition that causes partial or total hypopituitarism and is often associated with peripartum young women. We here report a 28-year-old patient who had a spontaneous and uneventful pregnancy following LH that had been treated with transspenoidal surgery and followed by anti-inflammatory agent. The woman failed to lactate and developed frontal headaches 3 months after normal delivery of her first child 3 years ago. Lab test showed the reduced concentrations of thyroxine, estradial and cortisol, suggesting hypopituitarism. Magnetic resonance imaging of the brain with contrast was performed and showed a uniformly enhancing pituitary mass with elevated optic chiasm. She underwent transsphenoidal surgery and histological examination of the resected specimen was consistent with lymphocytic hypophysitis. Anti-inflamation was started with prednisolone 40 mg per day because of a recurrence of headache that had completely recovered after surgery and regularly withdrawn to a long term maintenance dose of 10 mg per day. Physiological thyroxine replacement therapy was maintained. Her menstruation was restored without sex hormone replacement after 3 months. Three years after surgery, she got pregnant spontaneously and had normal breastfeeding after delivery. LH did not recur during this peripartum.
Department of Endocrinology, Peking University First Hospital, Beijing 100034, China.
Ai-mei
AM
Dong
Hong-fang
HF
Yin
Yan-ming
YM
Gao
Xiao-hui
XH
Guo
D000328:Adult; D001327:Autoimmune Diseases / Q000628:therapy; D005260:Female; D006801:Humans; D007018:Hypopituitarism / Q000209:etiology / Q000628:therapy*; D007249:Inflammation / Q000150:complications / Q000628:therapy; D008218:Lymphocytosis / Q000628:therapy; D010900:Pituitary Diseases / Q000150:complications / Q000473:pathology / Q000628:therapy*; D011247:Pregnancy