title: Use of a clinicoradiological score to determine the presurgical diagnosis of autoimmune hypophysitis in a teenage girl.
abstract: The distinction between autoimmune hypophysitis and other non-hormone secreting pituitary masses is often difficult to determine with certainty without pituitary biopsy and pathological examination. To aid in this distinction, the authors recently published a clinicoradiological scoring system, which they used in the case of a 15-year-old girl presented here. The patient presented with headache, visual field defects, polydipsia, and polyuria, and she was found to have secondary hypogonadism and hypoadrenalism. Magnetic resonance imaging showed a pituitary mass of approximately 2 cm in diameter. Application of the clinicoradiological parameters gave a score of -6, which favored a diagnosis of hypophysitis over that of adenoma. The presence of pituitary autoantibodies substantiated the diagnosis of hypophysitis. The patient was treated conservatively with high-dose prednisolone, and her symptoms improved markedly. This case illustrates the utility of using a clinicoradiological score when autoimmune hypophysitis is suspected since it can identify patients who can be treated without the need for pituitary surgery.
authors.affiliation: Departments of Neurosurgery, Gutenberg Medical University Mainz, Germany.
authors.forename: Vivek
authors.initials: V
authors.lastname: Bose
authors.forename: Patrizio
authors.initials: P
authors.lastname: Caturegli
authors.forename: Jens
authors.initials: J
authors.lastname: Conrad
authors.forename: Wael
authors.initials: W
authors.lastname: Omran
authors.forename: Stephan
authors.initials: S
authors.lastname: Boor
authors.forename: Alf
authors.initials: A
authors.lastname: Giese
authors.forename: Angelika
authors.initials: A
authors.lastname: Gutenberg
mesh_terms: D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D007018:Hypopituitarism / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D008279:Magnetic Resonance Imaging; D010902:Pituitary Gland / Q000473:pathology; D010907:Pituitary Hormones / Q000097:blood; D011239:Prednisolone / Q000627:therapeutic use; D011859:Radiography; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D010907:Pituitary Hormones; D011239:Prednisolone