摘要
目的总结干燥综合征并发淋巴细胞性垂体炎的临床特点和诊治经验,提高临床对该病的认识水平。方法分析山西医科大学第二附属医院风湿科收治的一例干燥综合征并发淋巴细胞性垂体炎患者的一般情况、临床表现、实验室检查、治疗及预后,对其进行长达10年的随访,并进行相关文献复习。结果患者10年前出现口干、眼干、视物不清、多尿多饮等症状,头颅MRI示鞍内垂体饱满,垂体柄增粗,确诊"原发性干燥综合征合并淋巴细胞性垂体炎",规律随访,给予小剂量激素联合免疫抑制剂治疗,现患者多尿多饮症状消失,头颅MRI示垂体结构大小正常,口干、眼干较前减轻。结论干燥综合征并发淋巴细胞性垂体炎的临床表现多样,除口干、眼干等干燥综合征的表现外,神经垂体受损的症状如多尿、多饮,头痛、视力障碍等症状常见。临床诊断应综合分析其临床表现、血清免疫学检查、影像学表现等结果,糖皮质激素治疗效果好,联合免疫抑制剂可有效防止复发。
Objective To summarize clinical features and therapeutic experience of Sjogren syndrome accompanied with lymphcytic hypophysitis and improve clinical knowledge to the disease. Methods To analyze basic characteristics, clinical manifestations, laboratory examination, therapy and prognosis, and review relative literatures. Results The patient developed dry mouth, dry eyes, blurred vision, diuresis and polydipsia ten years before. Cranial MRI showed plump pituitary in sella turcica and thickening stalk hypophysial. Primary Sjogren syndrome accompanied by lymphcytic hypophysitis was diagnosed. The therapy of regular steroid accompanying with immunosuppressant was given. The symptoms of diuresis and polydipsia were disappeared. And the symptoms of dry mouth and dry eyes were improved. Cranial MRI showed that the size of pituitary was normal. Conclusions The clinical manifestations of Sjogren syndrome accompanied with lymphcytic hypophysitis were multiform. Besides the symptoms of Sjogren syndrome, such as dry mouth and dry eyes, and the symptoms of destroyed pituitary, such as diuresis and polydipsia, the symptoms of headache and blurred vision are also very frequent. Clinical diagnosis should be based on clinical features, serological immunological examination, image manifestations, etc. The effect of glucocorticoids are good and combining of immunosuppressant can prevent relapse effectively.
出处
《中华临床医师杂志（电子版）》
CAS
2017年第1期83-86,共4页
Chinese Journal of Clinicians(Electronic Edition)
关键词
干燥综合征
淋巴细胞性垂体炎
治疗
随访
Sjogren syndrome
Lymphcytic hypophysitis
Treatment
Follow-up
