[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40 mg per day because of a recurrence of headache that had completely recovered after surgery and regularly withdrawn to a long term maintenance dose of 10 mg per day.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.
Dong
Ai-mei
AM
Department of Endocrinology, Peking University First Hospital, Beijing 100034, China.
Yin
Hong-fang
HF
Gao
Yan-ming
YM
Guo
Xiao-hui
XH
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