在ANCA相关的血管炎中垂体的参与:病例报告和文献综述
Xin Chen1,2, YiFan Xie2, MengLi Xu3
1Department of Rheumatology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China.
Medicine
|January 24, 2026
概括
反中性细胞质抗体 (ANCA) 相关的血管炎可能会影响下垂体,导致激素缺乏. 使用类固醇和免疫抑制剂的早期积极治疗可以改善垂体功能和整体健康.
科学领域:
- 内分泌学 在内分泌学.
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
背景情况:
- 反中性细胞质抗体 (ANCA) 相关的血管炎 (AAV) 是一种罕见的自身免疫性疾病,影响小血管.
- 在AAV中,垂体的参与是不常见的,但可以表现为中央无味糖尿病和全垂体性垂体病.
研究的目的:
- 在AAV中描述两个脑下垂体参与的病例.
- 审查关于AAV中的垂体功能障碍的文献,并讨论治疗结果.
主要方法:
- 关于两名患有AAV和垂体干扰的患者的病例报告.
- 在AAV中对垂体参与的研究的文献综述.
- 对临床表现,成像和治疗反应的分析.
主要成果:
- 这两名患者都呈现了脑下垂体功能障碍,由阳性ANCA标位和髓氧化酶抗体证实.
- 磁共振成像显示下垂体腺扩大; 一名患者还患有拉特克裂囊.
- 文献综述表明,42.55%的AAV患者在发病时表现出垂体功能障碍,通常伴有无味糖尿病和激素缺乏.
- 用类固醇,免疫抑制剂和生物药物的积极治疗导致临床症状和垂体成像显著改善.
结论:
- 下垂体干扰是AAV的重要并发症,可以呈现出各种内分泌功能障碍.
- 早期和积极的治疗策略,包括葡萄糖皮质类药物和免疫抑制药物,在治疗脑下垂体参与的AAV方面是有效的.
- 虽然全身性疾病可以实现缓解,但持续的垂体功能障碍仍然是患者的一个子集的担忧.
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