Use of a clinicoradiological score to determine the presurgical diagnosis of autoimmune hypophysitis in a teenage girl.
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| Abstract |
The distinction between autoimmune hypophysitis and other non-hormone secreting pituitary masses is often difficult to determine with certainty without pituitary biopsy and pathological examination. To aid in this distinction, the authors recently published a clinicoradiological scoring system, which they used in the case of a 15-year-old girl presented here. The patient presented with headache, visual field defects, polydipsia, and polyuria, and she was found to have secondary hypogonadism and hypoadrenalism. Magnetic resonance imaging showed a pituitary mass of approximately 2 cm in diameter. Application of the clinicoradiological parameters gave a score of -6, which favored a diagnosis of hypophysitis over that of adenoma. The presence of pituitary autoantibodies substantiated the diagnosis of hypophysitis. The patient was treated conservatively with high-dose prednisolone, and her symptoms improved markedly. This case illustrates the utility of using a clinicoradiological score when autoimmune hypophysitis is suspected since it can identify patients who can be treated without the need for pituitary surgery.
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| Authors | Vivek Bose, Patrizio Caturegli, Jens Conrad, Wael Omran, Stephan Boor, Alf Giese, Angelika Gutenberg |
| Journal | Journal of neurosurgery. Pediatrics (J Neurosurg Pediatr) Vol. 11 Issue 3 Pg. 335-9 (Mar 2013) ISSN: 1933-0715 [Electronic] United States |
| PMID | 23289917 (Publication Type: Case Reports, Journal Article, Research Support, N.I.H., Extramural) |
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