Rare Manifestations of Common Diseases: Middle-Aged Male Polyuria-Headache-Inflammatory Granulomatous Lesions
10.12376/j.issn.2097-0501.2023.03.007
- VernacularTitle:常见疾病的罕见表现: 中年男性多尿-头痛-炎症肉芽肿性病变
- Author:
Yuxing ZHAO
1
,
2
;
Lian DUAN
1
,
2
;
Wei LYU
2
,
3
;
Yong YAO
2
,
4
;
Hui YOU
2
,
5
;
Wen ZHANG
2
,
6
;
Jin MA
2
,
7
;
Xinxin MAO
2
,
8
;
Huijuan ZHU
1
,
2
Author Information
1. Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &
2. Peking Union Medical College, Beijing 100730, China.
3. Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &
4. Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &
5. Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &
6. Department of Rheumatology and Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &
7. Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &
8. Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &
- Publication Type:Journal Article
- Keywords:
pituitary tuberculosis;
sellar mass;
panhypopituitarism;
hypophysitis
- From:
JOURNAL OF RARE DISEASES
2023;2(3):359-364
- CountryChina
- Language:Chinese
-
Abstract:
A middle-aged man was presented with poor appetite, polyuria, polydrpsia, and headache. A sellar mass was found, along with total pituitary hypofunction and visual field defect. A biopsy of the lesion via the trans-sphenoidal approach showed inflammatory changes and granuloma formation. However, repeated cerebrospinal fluid and pathogenic examination of the pathological tissue showed no positive indications. The initial diagnosis considered autoimmune hypophysitis, and treatment of glucocorticoids combined with immunosuppressants was administered, which led to a temporary shrinkage of the lesion, but it gradually enlarged subsequently. After multidisciplinary discussion, a high possibility of pituitary tuberculosis infection was decided upon. After standardized anti-tuberculosis treatment was initiated, the lesion reduced noticeably and the patient′s condition improved. Pituitary tuberculosis infection is incredibly rare and extremely easy to misdiagnose. This case was diagnosed and treated in a timely and effective manner through a multidisciplinary approach, highlighting the importance of such an approach in dealing with rare diseases.
