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Lymphocytic adenohypophysitis presenting as infertility. Case report
1Clinical Neurosurgery Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland.
Journal of Neurosurgery
|May 1, 1991
Summary
This study details a rare case of lymphocytic adenohypophysitis causing infertility and hyperprolactinemia in a nulliparous patient. The research provides novel immunological insights into this pituitary disorder.
Area of Science:
- Endocrinology
- Immunology
- Reproductive Medicine
Background:
- Lymphocytic adenohypophysitis is an uncommon autoimmune condition affecting the pituitary gland.
- It can present as pituitary enlargement, mimicking a tumor, and is often associated with hyperprolactinemia.
- Typically observed in women during or after pregnancy, it is rarely linked to infertility.
Observation:
- A nulliparous patient presented with infertility and hyperprolactinemia due to pituitary enlargement unresponsive to bromocriptine.
- Surgical removal revealed adenohypophysitis with a significant lymphocytic infiltrate.
- Immunohistochemical analysis characterized the lymphocyte subsets and immune markers within the pituitary tissue.
Findings:
- CD4+ helper-inducer T-lymphocytes and interleukin-2 receptor expression were prominent, indicating cellular immune activation.
- B lymphocytes and macrophages were also present, with immune markers correlating to these cells.
- This detailed immunological profile of the pituitary infiltrate is novel for lymphocytic adenohypophysitis.
Implications:
- This case expands the known clinical spectrum of lymphocytic adenohypophysitis to include infertility.
- The findings highlight the importance of considering autoimmune pituitary disorders in cases of unexplained infertility and hyperprolactinemia.
- Further research into the immunological mechanisms of adenohypophysitis may reveal new therapeutic targets.