Analysis Of 23 Hypophysitis Cases Diagnosed Clinically Or Pathologically And Review Of Literature

OBJECTIVE To explore the diagnosis and management of pituitary hypophysitis. METHODS To summarize and analyze the 23 cases diagnosed both clinically (10 cases) and pathologically (13 cases) during September 1998 to September 2009 in Peking Union Medical College Hospital and Second Affiliated Hospital of Zhejiang University. RESULTS The median age is 37-year-old and the median course is 4 months. Diabetes inspidus, headache, hypopituitarism, visual function defect are the common manifestations. MRI (Magnetic resonance imaging) revealed sellar lesion with homo-intense T1 signal and homo-intense T2 signal, which like to grow upward, pituitary stalk enlargement, homogenous enhancement and loss of posterior pituitary bright spot. Patients got noticeable remission after Trans-sphenoidal surgery (13 cases) and conservative treatment (glucocorticoid and replacement therapy) in other patients. CONCLUSIONS Pre-operation diagnosis of pituitary hypophysitis is difficult. Trans-sphenoidal surgery should be suggested in patients with clinical signs, accompanied by glucocorticoid and replacement.