Differentiating lymphocytic adenohypophysitis from pituitary adenoma in the peripartum patient

E. K. Pressman, S. M. Zeidman, U. M. Reddy, J. I. Epstein, H. Brem

Research output: Contribution to journalArticlepeer-review

Abstract

Lymphocytic adenohypophysitis (LAH) is an autoimmune disorder of the pituitary gland with a predilection for the peripartum period and often mimics a pituitary adenoma. We sought to define the clinical, endocrinologic and radiographic characteristics differentiating peripartum LAH from pituitary adenoma to enable the use of noninvasive diagnosis and appropriate therapy. From published reports and our own case, the clinical histories and laboratory and radiographic studies of 45 patients fulfilling the diagnosis of peripartum LAH were reviewed. History of infertility or menstrual irregularity, symptomatology, endocrinologic evaluation, diagnostic imaging and associated medical conditions were analyzed. For comparison, 806 patients with pituitary adenoma and pregnancy from published series were evaluated. The spontaneous pregnancy rate in pituitary adenoma patients was 2.4% vs. 100% in LAH patients. Visual disturbances and headaches were significantly more frequent in patients with LAH. Prolactin levels were significantly lower in patients with LAH than in those with pituitary adenomas (34.6 ± 46.3 [SD] vs. 393.0 ± 300.4, P <.0001). Abnormalities in thyroid and/or adrenal function were also more common in patients with LAH (57.5% vs. 2.5%, P < .001). There were no distinguishing characteristics on radiographic studies. History and endocrinologic evaluation can differentiate between LAH and pituitary adenoma in the peripartum patient.

Original languageEnglish (US)
Pages (from-to)251-259
Number of pages9
JournalJournal of Reproductive Medicine for the Obstetrician and Gynecologist
Volume40
Issue number4
StatePublished - Apr 26 1995

Keywords

  • adenohypophysis
  • pituitary adenoma, prolactin-secreting
  • pregnancy complications

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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