Autoimmune Hypophysitis Treated with Intravenous Glucocorticoid Therapy

• Miyake Ikuyo

  Division of Endocrinology and Metabolism, Department of Medicine, Kurume University School of Medicine

• Takeuchi Yasuharu

  Division of Neurosurgery, Kurume University School of Medicine

• Kuramoto Terukazu

  Division of Neurosurgery, Kurume University School of Medicine

• Kaku Hiroo

  Division of Endocrinology and Metabolism, Department of Medicine, Kurume University School of Medicine

• Nakayama Hitomi

  Division of Endocrinology and Metabolism, Department of Medicine, Kurume University School of Medicine

• Takata Kazuna

  Division of Endocrinology and Metabolism, Department of Medicine, Kurume University School of Medicine

• Kurita Yayoi

  Division of Endocrinology and Metabolism, Department of Medicine, Kurume University School of Medicine

• Shigemori Minoru

  Division of Neurosurgery, Kurume University School of Medicine

• Hiromatsu Yuji

  Division of Endocrinology and Metabolism, Department of Medicine, Kurume University School of Medicine

• Yamada Kentaro

  Division of Neurosurgery, Kurume University School of Medicine

抄録

A 46-year-old man presented with frontal headache, a visual field defect and general fatigue. Magnetic resonance imaging (MRI) of the brain showed symmetrical enlargement of the pituitary gland and stalk due to the presence of a mass lesion extending toward the optic chiasm. Gadolinium injection further revealed homogeneous strong enhancement with involvement of the adjacent dura (dural tail). Basal plasma levels of ACTH, free thyroxine and gonadotropins were decreased, and 24-h urinary 17-OHCS excretion was reduced. An elevated anti-thyroglobulin antibody titer indicated the presence of autoimmune thyroiditis. Under the suspicion of autoimmune hypophysitis, 60 mg/day prednisolone sodium succinate was intravenously administered for two weeks followed by a decreasing dose of oral prednisolone. Clinical symptoms and pituitary dysfunction recovered during steroid treatment and MRI showed marked shrinkage of the pituitary mass. Early initiation of an intravenous dose of glucocorticoid followed by oral steroid administration therefore seems to be an efficient treatment for autoimmune hypophysitis even in patients with visual dysfunction.<br>

収録刊行物

• Internal Medicine

  Internal Medicine 45 (21), 1249-1252, 2006

  一般社団法人 日本内科学会

キーワード

• autoimmune hypophysitis
• intravenous glucocorticoid
• autoimmune thyroiditis
• hypopituitarism
• magnetic resonance imaging

詳細情報

• CRID: 1390001204873568768
• NII論文ID: 130000076617
• DOI: 10.2169/internalmedicine.45.1750
• ISSN: 13497235
• ISSN: 09182918
• Web Site: http://www.jstage.jst.go.jp/article/internalmedicine/45/21/45_21_1249/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2007249929
• 本文言語コード: en
• データソース種別:
  • JaLC
  • Crossref
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可