Pituitary disorders in pregnancy

Chrisoulidou, Alexandra; Boudina, Maria; Karavitaki, Niki; Bili, Eleni; Wass, John

doi:10.1007/bf03401382

Cited by 22 publications

(19 citation statements)

References 96 publications

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“…However, nowadays, non‐invasive diagnosis of LAH is feasible by pituitary MRI and endocrinological deficit patterning . When clinical suspicion of LAH is high following laboratory testing or physical examination, a contrast‐enhanced pituitary MRI is very helpful for diagnosis . An MRI demonstrates symmetrical pituitary enlargement, strong and homogeneous contrast enhancement of the pituitary gland, diffuse thickening of the pituitary stalk and loss of the ‘bright spot’ of the neurohypophysis; such characteristic findings of LAH are the clues for differentiation from a pituitary adenoma …”

Section: Discussionmentioning

confidence: 99%

“…Lymphocytic hypophysitis (LH) is a very rare autoimmune disease characterized by lymphocytic infiltration and destruction of the pituitary gland . The annual incidence of LH can be estimated at one case per 9 million .…”

Section: Introductionmentioning

confidence: 99%

“…Lymphocytic hypophysitis (LH) is a very rare autoimmune disease characterized by lymphocytic infiltration and destruction of the pituitary gland. 1 The annual incidence of LH can be estimated at one case per 9 million. 2 Based on the affected area of the pituitary gland, LH can be classified as lymphocytic adenohypophysitis (LAH), which involves only the anterior pituitary lobe, lymphocytic infundibuloneurohypophysitis, which involves only the posterior pituitary lobe, and lymphocytic panhypophysitis, which involves both pituitary lobes.…”

Section: Introductionmentioning

confidence: 99%

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Post‐partum hypoglycemia and hypothermia as first manifestations of lymphocytic adenohypophysitis: A case report

Koyama

Okuno

Naoi

et al. 2016

J of Obstet and Gynaecol

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Lymphocytic adenohypophysitis is a very rare autoimmune disease characterized by an anterior pituitary infiltration of lymphocytes that cause various symptoms, such as headache, visual disturbance, and hypopituitarism. Lymphocytic adenohypophysitis is more common in women and has a remarkable association with the perinatal period. Recently, we experienced a case of lymphocytic adenohypophysitis shortly after delivery. A 37-year-old primiparous woman delivered her baby at 38 weeks' gestation. The next morning, she presented symptoms of hypoglycemia and hypothermia. Blood testing revealed hypoadrenalism and hypothyroidism. Pituitary magnetic resonance imaging showed characteristic findings consistent with lymphocytic adenohypophysitis. We immediately initiated medication with steroids and levothyroxine. Currently, her pituitary size has normalized and its function has fully recovered. Physical stress resulting from labor and delivery may unmask subclinical lymphocytic adenohypophysitis. Practitioners should keep in mind the possibility of lymphocytic adenohypophysitis in any pregnant women with symptoms of hypoglycemia and hypothermia after delivery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Post‐partum hypoglycemia and hypothermia as first manifestations of lymphocytic adenohypophysitis: A case report

Koyama

Okuno

Naoi

et al. 2016

J of Obstet and Gynaecol

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“…Prolactinomas, representing about 40% of all pituitary adenomas in the general population, are the most common causes of pituitary enlargement during pregnancy. [1] Nonfunctioning pituitary adenomas (NFPAs), accounting for approximately 25 to 35% of pituitary tumors, are not common during pregnancy. [2] This can be explained by the fact that they are associated with decreased fertility in these patients, due to impairm e n t i n g o n a d o t r o p i n s e c r e t i o n a n d / o r hyperprolactinemia, prevalent in 36-96% of patients with macroadenomas.…”

Section: Introductionmentioning

confidence: 99%

“…[2] This can be explained by the fact that they are associated with decreased fertility in these patients, due to impairm e n t i n g o n a d o t r o p i n s e c r e t i o n a n d / o r hyperprolactinemia, prevalent in 36-96% of patients with macroadenomas. [1,3] The growth of NFPA during pregnancy is unexpected, as estrogenic stimulation does not seem to influence this kind of adenoma. [3] This article reports the case of a hirsute woman diagnosed with NFPA that led to visual field abnormalities during her second spontaneous pregnancy, representing the largest NFPA diagnosed in a pregnant woman.…”

Section: Introductionmentioning

confidence: 99%

Large Nonfunctioning Pituitary Adenoma Presenting with Visual Loss During Late Pregnancy—Challenges in Management

Terhes

Baciu

Curt

et al. 2019

SN Compr. Clin. Med.

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Nonfunctioning pituitary adenomas (NFPA) are very rare during pregnancy since fertility is usually impaired. A 31 year old hirsute woman was referred to the Endocrine Clinic for a large pituitary tumor, discovered at 35 weeks of gestation. She complained of increasing headache and abnormal vision, particularly in her left eye in the previous few weeks. An MRI scan showed a pituitary mass: 3.1 ×2.7 ×1.8 cm (LL/CC/AP) with suprasellar extension, and compression of the optic chiasm. Serum prolactin and the results of other endocrine investigations were normal, so she was diagnosed with NFPA. Both inducing labour or medication (bromocriptine) administration while proceeding to a safe term for pregnancy were considered. However, we chose to only follow her closely. There was no further deterioration and, at 38 weeks, a caesarian section was performed and a healthy boy was delivered. Two weeks after delivery, she underwent craniotomy (by right lateral subfrontal approach) with resection of the NFPA, followed by complete regression of the visual disturbances. The postoperative MRI demonstrated empty sella and no residual tumor, while the hormonal evaluation detected no significant pituitary insufficiency. Although cost-effective, combined histologic and immunophenotypic studies, especially extended IHC tests, can reduce the incidence of misdiagnosed large-cell lymphoma. As exemplified in this present case, obtaining appropriate and sufficient tissue from the tumor could possibly increase the chance of finding an accurate diagnosis.

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