PMC5409939_01
Anterior pituitary tolerance tests. (A) Responses of TRH to i.v. injection of TRH (500 mug). (B) Responses of adrenal hormones to i.v. injection of CRH (100 mug). (C) Responses of ACTH to i.v. injection of CRH (100 mug).
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As shown in Fig. 1A, TSH response to TRH was absent or low. Cortisol response to CRH was also not preserved in this subject although ACTH response to CRH was observed (Fig. 1B and C). FT4 and PRL levels were normalized, although LH, FSH and testosterone levels remained low. Furthermore, as shown in Fig. 1A, TSH response to TRH was markedly improved in the hormone-loading tests.
Enhanced magnetic resonance imaging (MRI) with T1-weighted image. (A) Swelling of the stalk and anterior lobe of patient pituitary on admission. (B) The improvement of such swelling of them 3 months later.
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Furthermore, pituitary-enhanced magnetic resonance imaging (MRI) showed swelling of the stalk and anterior lobe of his pituitary (Fig. 2A). Pituitary-enhanced MRI taken 3 months later showed a marked improvement (Fig. 2B).
Histopathological findings. (A) The hematoxylin and eosin staining of the pituitary gland (magnification x20). (B) IgG4 staining of the pituitary gland (x40). There was a marked infiltration of lymphocyte and plasma cells. There was about 30% of IgG4-positive plasma cells, which were accounted for IgG-positive cells.
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