[1例淋巴细胞性垂体炎最初诊断为无菌性脑膜炎]。

Q4 Medicine
Eito Miura, Uran Komatsubara, Yoshitaka Umeda, Shota Akakabe, Nobuya Fujita, Mutsuo Oyake
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引用次数: 0

摘要

一个57岁的男人表现为头痛和发烧,并被诊断为无菌性脑膜炎的基础上脑脊液多细胞增多。一个月后,症状加重,嗜睡也出现。虽然包括电解质和肌酸激酶在内的一般血液检查未显示异常,但脑MRI (gd增强)显示整个垂体肿大,并扩散到茎部。荷尔蒙测试显示泛垂体功能低下在排除了结节病、梅毒、肺结核、Sjögren综合征和系统性红斑狼疮等可能导致垂体炎的疾病后,诊断为淋巴细胞性垂体炎。激素替代疗法改善了症状和脑下垂体肿大。该病例被认为是不典型淋巴细胞性垂体炎,一般血液检查没有异常,这在考虑无菌性脑膜炎的鉴别诊断时是必不可少的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[A case of lymphocytic hypophysitis initially diagnosed as aseptic meningitis].

A 57-year-old man presented with headache and fever, and was diagnosed as having aseptic meningitis on the basis of CSF pleocytosis. One month later, the symptoms became exacerbated, and lethargy also developed. Although general blood tests including electrolytes and creatine kinase showed no abnormalities, brain MRI with Gd-enhancement revealed enlargement of the whole pituitary gland, spreading to the stalk. Hormonal tests revealed pan-hypopituitarism. After ruling out diseases such as sarcoidosis, syphilis, tuberculosis, Sjögren syndrome and systemic lupus erythematosus, which could potentially cause hypophysitis, lymphocytic hypophysitis was diagnosed. Hormone replacement therapy ameliorated both the symptoms and the enlargement of the pituitary gland. This case was considered to be atypical lymphocytic hypophysitis, lacking abnormalities in general blood tests, which is essential when considering a differential diagnosis of aseptic meningitis.

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来源期刊
Clinical Neurology
Clinical Neurology Medicine-Neurology (clinical)
CiteScore
0.30
自引率
0.00%
发文量
147
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