Recurrent idiopathic granulomatous hypophysitis: learnings through case studies

VernacularTitle:病情反复的特发性肉芽肿性垂体炎疗效分析
Author: Shuo ZHANG ¹ ; Qing MIAO ; Haixia CHENG ; Hongying YE
Author Information

1. 复旦大学附属华山医院内分泌科，上海　200040
Keywords: Granulomatous hypophysitis; Azathioprine; Glucocorticoid
From: Chinese Journal of Endocrinology and Metabolism 2022;38(5):430-432
CountryChina
Language:Chinese
Abstract: 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.