6533b85efe1ef96bd12bff22
RESEARCH PRODUCT
Use of a clinicoradiological score to determine the presurgical diagnosis of autoimmune hypophysitis in a teenage girl.
Alf GieseJens ConradPatrizio CaturegliVivek BoseSteph An BoorAngelika GutenbergWael Omransubject
Pituitary glandmedicine.medical_specialtyPathologyAdenomaAdolescentHypophysitisPrednisoloneAnti-Inflammatory AgentsHypopituitarismHypopituitarismAutoimmune DiseasesPolyuriaHypoadrenalismmedicineHumansbusiness.industryHeadacheGeneral Medicinemedicine.diseaseMagnetic Resonance ImagingRadiographyPituitary Hormonesmedicine.anatomical_structureTreatment OutcomePituitary GlandAutoimmune hypophysitisPrednisoloneFemaleRadiologymedicine.symptombusinessmedicine.drugdescription
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.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2013-03-01 | Journal of neurosurgery. Pediatrics |