RESUMO
BACKGROUND: Lymphocytic hypophysitis is a rare autoimmune condition that usually presents during pregnancy and causes inflammation of the pituitary gland. Although the pathophysiology is not well understood, it often presents with headaches, visual disturbances, and symptoms of hypopituitarism. However, not all cases may present with hypopituitarism which can make this rare disease with an incidence of ~ 1 in 9 million much more difficult to diagnose. CASE PRESENTATION: We present a 35-year-old G4P4 woman with progressive vision loss and intermittent frontal headaches during her first trimester through 2 months postpartum. She presented with no symptoms of hypopituitarism and her hormone panel only showed elevated prolactin, possibly due to her breastfeeding. She was treated with a right pterional craniotomy with decompression of both optic nerves, partial resection of the suprasellar mass, and glucocorticoid therapy for headaches and visual disturbances. CONCLUSION: This case is notable for a presentation of lymphocytic hypophysitis without symptoms of hypopituitarism. This is important for outpatient providers to be aware of, especially those that care for pregnant patients so that unfavorable outcomes can be avoided.
Assuntos
Hipofisite Autoimune , Hipopituitarismo , Doenças da Hipófise , Neoplasias Hipofisárias , Humanos , Gravidez , Feminino , Adulto , Neoplasias Hipofisárias/complicações , Neoplasias Hipofisárias/diagnóstico , Neoplasias Hipofisárias/cirurgia , Hipofisite Autoimune/diagnóstico , Hipofisite Autoimune/complicações , Doenças da Hipófise/diagnóstico , Doenças da Hipófise/complicações , Hipopituitarismo/diagnóstico , Hipopituitarismo/etiologia , Hormônios Hipofisários , Cefaleia/etiologia , Cefaleia/complicações , Imageamento por Ressonância MagnéticaRESUMO
Diabetic muscle infarction (DMI) is a rare complication of poorly controlled type 1 and type 2 diabetes seen mostly in those who have already experienced microvascular complications. Currently, the incidence and prevalence of DMI are difficult to conclude, and there is no clear algorithm or standard of care in managing this condition. Pathogenesis of the microangiopathy of DMI remains unclear. A major finding in this investigation of DMI emphasizes that, within 2-17 weeks, patients who initiate low-dose acetylsalicylic acid, bed rest, and close outpatient follow-up see significant size reduction of lower extremity mass and complete resolution of pain without being subjected to invasive muscle biopsy.
