ステロイドパルス療法が奏効したリンパ球性下垂体炎の1例

A Case of Lymphocytic Hypophysitis Successfully Treated with Steroid Pulse Therapy

Ⅰ．緒言

　リンパ球性下垂体炎は下垂体組織にリンパ球が浸潤し腫瘤を形成する疾患で，下垂体に臓器特異的に生じる自己免疫疾患と考えられている．今回われわれは，ステロイドパルス療法が有効であったリンパ球性下垂体炎の1例を経験したので報告する．

　Lymphocytic hypophysitis is an autoimmune disorder of the pituitary gland. We report a case of lymphocytic hypophysitis managed by high dose methylprednisolone pulse therapy and review the literature. A 61-year-old woman presented with severe headache. Magnetic resonance imaging (MRI) revealed a contrast enhancing pituitary mass. The patient underwent endonasal-transsphenoidal surgery of the pituitary lesion under the diagnosis of a non-secreting pituitary adenoma. Intraoperative histological findings suggested an inflammatory lesion and we performed subtotal resection of the mass. Histopathological examination confirmed the diagnosis of lymphocytic hypophysitis. Postoperatively, she received methylprednisolone pulse therapy and her severe headache resolved. This case report suggests that methylprednisolone pulse therapy may improve the clinical symptoms of lymphocytic hypophysitis.