摘要
通过回顾分析3例病理确诊的病情反复的肉芽肿性垂体炎患者起病时临床表现、实验室和影像学特点及术后治疗方案和疗效,总结、分析、讨论病情反复的肉芽肿性垂体炎临床特点和治疗方案及疗效,以提高对其认识,提供可借鉴的治疗经验。3例患者分别因头痛、视物模糊、中枢性尿崩症就诊,MRI发现鞍区或垂体柄占位,行大部切除或活检术后症状未完全缓解而使用糖皮质激素治疗可控制症状和病灶,但激素减量后复发。2例联合硫唑嘌呤治疗后有效控制,其中1例停药后随访14个月未见复发,1例仍在治疗中。因此对于术后症状未缓解,糖皮质激素减量后病情反复的患者,联合免疫抑制剂硫唑嘌呤的方案或可达到满意疗效和预后。
In this article,we summarize clinical features and management of 3 cases with pathology confirmed granulomatous hypophysitis,to improve knowledge and provide treatment guidance in this regards.Patients presented with headache,blurred vision and central diabetes insipidus,respectively.The imaging manifestations were sellar area or pituitary stalk occupying lesions,and the nature was undetermined.The symptoms were not completely relieved after subtotal resection or biopsy.The symptoms could be controlled by high dose glucocorticoid,but relapsed after reduction.Two patients were treated with glucocorticoid combined with azathioprine.One case had no recurrence after withdrawal of the drug and 1 patient was still in treatment.Therefore,for the patients whose symptoms are still not relieved after operation and recurred after glucocorticoid reduction,the scheme of high-dose glucocorticoid combined with immunosuppressant azathioprine can be considered,which may achieve satisfactory curative effect and prognosis.
作者
张烁
苗青
程海霞
叶红英
Zhang Shuo;Miao Qing;Cheng Haixia;Ye Hongying(Department of Endocrinology and Metabolism,Huashan Hospital,Fudan University,Shanghai 200040,China;Department of Pathology,Huashan Hospital,Fudan University,Shanghai 200040,China)
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2022年第5期430-432,共3页
Chinese Journal of Endocrinology and Metabolism
