Isabela Morales Cozeto1, Lívia Norcia Zenerato1, Letícia Alarcão Maxta2, Ricardo Baer Filho1, Érico Paulo Heilbrun3, Márcio Luis Duarte4,5 and Lucas Ribeiro dos Santos3,5*
1Medical Student at Medical Sciences, Faculty of Santos, Santos, São Paulo, Brazil
2Endocrinologist at A.C. Camargo Center, São Paulo, Brazil
3Professor of Endocrinology, Medical Sciences, Faculty of Santos, Santos, São Paulo, Brazil
4Radiologist, Medical Residency Coordinator at Webimagem, São Paulo, Brazil
5Masters in Evidence Based Health by UNIFESP, São Paulo, Brazil
*Corresponding Author: Lucas Ribeiro dos Santos, Professor of Endocrinology, Medical Sciences, Faculty of Santos, Santos, São Paulo, Brazil.
Received: March 31, 2020; Published: April 23, 2020
Lymphocytic or autoimmune hypophysitis (AH) is a rare disorder characterized by inflammation of the pituitary gland. There is no consensus on treatment, but may include corticosteroid therapy and decompression surgery. Optic neuritis (ON) is an inflammation of the optic nerve, both of unknown etiology and autoimmune hypothesis. The association of pathologies is rare, with few reports in the literature. The diagnosis of ON is clinical and treatment with high dose corticosteroids. A case initially diagnosed as ON with pituitary macroadenoma is described: 55-year-old woman with sudden bilateral visual loss associated with nausea, vomiting, diarrhea and hypotension, MRI with pituitary expansive lesion with optic chiasm compression and laboratory tests showing thyrotrophic, corticotrophic and gonadotropic axes deficiencies, associated with mild hyperprolactinemia. Methylprednisolone pulse therapy was performed for ON treatment. Patient presented improvement of visual acuity, decreased pituitary volume and recovery of corticotrophic axis, raising the hypothesis of AH. The case demonstrates the importance of careful neuro-ophthalmologic and radiographic evaluation of patients with pituitary adenoma and visual loss. NO and AH should be considered in the differential diagnosis as this may prevent unnecessary invasive procedures.
Keywords: Autoimmune Hypophysitis; Optic Neuritis; Pituitary Diseases; Hypopituitarism
Citation: Lucas Ribeiro dos Santos. “Optic Neuritis and Hypophysitis: Partial Remission after Pulse Therapy".Acta Scientific Neurology 3.4 (2020): 01-04.
Copyright: © 2020 Lucas Ribeiro dos Santos. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.