Short report
Lymphocytic hypophysitis: non-invasive diagnosis and treatment by
high dose methylprednisolone pulse therapy?
Rudolf A Kristofa, Dirk Van Roosta, Dietrich Klingmüllerb, Wolfram Springerb, Johannes Schramma
a Department of
Neurosurgery, University of Bonn, Germany, b Institute of
Biochemistry, Neuroendocrinology, University of Bonn, Germany
Correspondence to: Dr Rudolf A Kristof, Neurochirurgische Universitätsklinik, Sigmund-Freud-Strasse 25, D-53105 Bonn, Germany. Telephone 0049 228 287 6521; fax 0049 228 287 6772.
Received 15 May 1998 and in revised form 9 February 1999;
Accepted 16 February
1999
Criteria for the non-invasive diagnosis of lymphocytic
hypophysitis (LyHy) and the results of the first prospective trial of
high dose methylprednisolone pulse therapy (HDMPT) in nine patients are
presented. In three patients, the diagnosis was established histologically, and in the others by clinical and endocrinological assessment, MRI, CSF examination, and measurement of thyroglobulin autoantibody concentration. After HDMPT, adenopituitary function improved in four of the nine patients and diabetes insipidus ceased or
improved in all four concerned patients. The MRI findings improved in
seven patients. LyHy has to be considered in the differential diagnosis
of sellar lesions. The presumptive non-invasive diagnosis of LyHy seems
possible in a high proportion of patients. HDMPT may result in the
improvement of clinical, endocrinological, and MRI findings.
Keywords: lymphocytic hypophysitis; high dose methylprednisolone pulse therapy
© 1999 by Journal of Neurology, Neurosurgery, and Psychiatry
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