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Trigemino-autonomic headache and Horner syndrome as a first sign of granulomatous hypophysitis
OBJECTIVE: To report a rare case of incipient granulomatous hypophysitis presenting by atypical trigemino-autonomic cephalalgia (TAC) and Horner syndrome. METHODS: The patient was investigated with repeated brain MRI, CSF examination, thoracic CT, Doppler and duplex ultrasound of the cerebral arteri...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Lippincott Williams & Wilkins
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5310204/ https://www.ncbi.nlm.nih.gov/pubmed/28243612 http://dx.doi.org/10.1212/NXI.0000000000000332 |
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author | Motte, Jeremias Kreitschmann-Andermahr, Ilonka Fisse, Anna Lena Börnke, Christian Schroeder, Christoph Pitarokoili, Kalliopi Müller, Oliver Lukas, Carsten van de Nes, Johannes Buslei, Rolf Gold, Ralf Ayzenberg, Ilya |
author_facet | Motte, Jeremias Kreitschmann-Andermahr, Ilonka Fisse, Anna Lena Börnke, Christian Schroeder, Christoph Pitarokoili, Kalliopi Müller, Oliver Lukas, Carsten van de Nes, Johannes Buslei, Rolf Gold, Ralf Ayzenberg, Ilya |
author_sort | Motte, Jeremias |
collection | PubMed |
description | OBJECTIVE: To report a rare case of incipient granulomatous hypophysitis presenting by atypical trigemino-autonomic cephalalgia (TAC) and Horner syndrome. METHODS: The patient was investigated with repeated brain MRI, CSF examination, thoracic CT, Doppler and duplex ultrasound of the cerebral arteries, and extensive serologic screening for endocrine and autoimmune markers. Written informed consent was obtained from the patient for access to clinical files for research purposes and for publication. RESULTS: We present a middle-aged woman with a history of an autoimmune pancreatitis type 2 who had therapy-refractory TAC with Horner syndrome. Initial cerebral MRI showed only indistinct and unspecific signs of a pathologic process. A biopsy revealed a granulomatous hypophysitis. The symptoms disappeared after transsphenoidal subtotal resection of the pituitary mass and anti-inflammatory therapy. CONCLUSIONS: This case elucidates that inflammatory pituitary diseases must be taken into account in case of atypical and refractory TAC, especially in patients with a history of autoimmune diseases. To our knowledge, the association between TAC accompanied by Horner syndrome and hypophysitis has not yet been described before. |
format | Online Article Text |
id | pubmed-5310204 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-53102042017-02-27 Trigemino-autonomic headache and Horner syndrome as a first sign of granulomatous hypophysitis Motte, Jeremias Kreitschmann-Andermahr, Ilonka Fisse, Anna Lena Börnke, Christian Schroeder, Christoph Pitarokoili, Kalliopi Müller, Oliver Lukas, Carsten van de Nes, Johannes Buslei, Rolf Gold, Ralf Ayzenberg, Ilya Neurol Neuroimmunol Neuroinflamm Article OBJECTIVE: To report a rare case of incipient granulomatous hypophysitis presenting by atypical trigemino-autonomic cephalalgia (TAC) and Horner syndrome. METHODS: The patient was investigated with repeated brain MRI, CSF examination, thoracic CT, Doppler and duplex ultrasound of the cerebral arteries, and extensive serologic screening for endocrine and autoimmune markers. Written informed consent was obtained from the patient for access to clinical files for research purposes and for publication. RESULTS: We present a middle-aged woman with a history of an autoimmune pancreatitis type 2 who had therapy-refractory TAC with Horner syndrome. Initial cerebral MRI showed only indistinct and unspecific signs of a pathologic process. A biopsy revealed a granulomatous hypophysitis. The symptoms disappeared after transsphenoidal subtotal resection of the pituitary mass and anti-inflammatory therapy. CONCLUSIONS: This case elucidates that inflammatory pituitary diseases must be taken into account in case of atypical and refractory TAC, especially in patients with a history of autoimmune diseases. To our knowledge, the association between TAC accompanied by Horner syndrome and hypophysitis has not yet been described before. Lippincott Williams & Wilkins 2017-02-14 /pmc/articles/PMC5310204/ /pubmed/28243612 http://dx.doi.org/10.1212/NXI.0000000000000332 Text en Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Article Motte, Jeremias Kreitschmann-Andermahr, Ilonka Fisse, Anna Lena Börnke, Christian Schroeder, Christoph Pitarokoili, Kalliopi Müller, Oliver Lukas, Carsten van de Nes, Johannes Buslei, Rolf Gold, Ralf Ayzenberg, Ilya Trigemino-autonomic headache and Horner syndrome as a first sign of granulomatous hypophysitis |
title | Trigemino-autonomic headache and Horner syndrome as a first sign of granulomatous hypophysitis |
title_full | Trigemino-autonomic headache and Horner syndrome as a first sign of granulomatous hypophysitis |
title_fullStr | Trigemino-autonomic headache and Horner syndrome as a first sign of granulomatous hypophysitis |
title_full_unstemmed | Trigemino-autonomic headache and Horner syndrome as a first sign of granulomatous hypophysitis |
title_short | Trigemino-autonomic headache and Horner syndrome as a first sign of granulomatous hypophysitis |
title_sort | trigemino-autonomic headache and horner syndrome as a first sign of granulomatous hypophysitis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5310204/ https://www.ncbi.nlm.nih.gov/pubmed/28243612 http://dx.doi.org/10.1212/NXI.0000000000000332 |
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