青少年淋巴细胞性垂体炎4例并文献复习  

Lymphocytic hypophysitis in adolescents:A report of four cases and literature review

作　　者：陈雪峰 李一君[1] 杨国庆[1] 窦京涛[1] 吕朝晖[1] 母义明[1] Chen Xuefeng;Li Yijun;Yang Guoqing;Dou Jingtao;Lyu Zhaohui;Mu Yiming(Department of Endocrinology,the First Medical Center of PLA General Hospital,Beijing 100853,China;Department of Endocrinology,Wu′an First People’s Hosipital,Wu′an 056300,China)

机构地区：[1]解放军总医院第一医学中心内分泌科,北京100853 [2]武安市第一人民医院内分泌科,河北武安056300

出　　处：《临床荟萃》2021年第9期832-838,共7页Clinical Focus

摘　　要：分析2008年1月-2019年12月解放军总医院内分泌科诊治的青少年淋巴细胞性垂体炎患者的症状、体征、生化检查和垂体功能评价、影像学、治疗及随访资料。4例患者3例为女性,1例为男性,女性患者年龄分别为11、7、12岁,男性患者为17岁;病程3~36个月。①临床表现:1例有头痛,3例有尿崩症,3例有垂体前叶功能减退,1例有生长障碍。②影像学特点:磁共振成像(MRI)表现为垂体对称性增大伴均匀强化,伴垂体柄增粗,未侵犯视交叉及海绵窦。③诊疗转归:1例给予大剂量甲泼尼龙治疗,3例给予激素替代治疗。随访时间6~144个月,2例自发缓解,2例长期激素替代治疗,其中1例发生空泡蝶鞍。青少年鞍区占位需警惕淋巴细胞性垂体炎可能,青少年淋巴细胞性垂体炎预后多良好。To analyze the clinical data of 4 cases diagnosed as lymphocytic hypophysitis(LYH)in adolescents at PLA General Hospital between January 2008 to December 2019.There were 3 females and 1 male.The age of females were 11,7,12 years respectively,and the male was 17 years.The course of LYH ranged from 3 to 36 months.(1)Clinical features:1 patient had headache,3 patients had central diabetes insipidus(CDI),3 patients had hypopituitarism,and growth disorder was seen in 1 patient.(2)Imaging features:All patients had space-occupying lesions on magnetic resonance imaging(MRI),which were symmetrically enlarged and homogenously enhanced with pituitary stalk thickening,without extending into suprasellar area and compressing optic chiasm and cavernous sinus.(3)Treatments and outcomes:1 patient was treated with high dose methylprednisolone pulse therapy(HDMPT),3 patients with hormone replacement.The follow-up ranged from 6 to 144 months,2 patients were spontaneous remission,2 patients with hormone replacement permanently.One patient had empty sella,but the condition is necessary to realize the possibility of lymphocytic hypophysitis in adolescents and mostly expects good prognosis.

关 键 词：淋巴细胞性垂体炎 垂体前叶功能减退症 尿崩症 青少年 

分 类 号：R584[医药卫生—内分泌]