Follow-up Studies of Optic Neuritis with Lymphocytic Adenohypophysitis

Abstract

We report a 38-year-old female suffering from bilateral optic neuritis with lymphocytic adenohypophysitis. The initial symptom of the 38-year-old-female was diabetes insipidus. Magnetic resonance imaging showed swollen pituitary stalk and disappearance of the T1 shortening of the neurohypophysis. Immunological tests showed that the serum anterior pituitary antibody was positive. These findings suggested lymphocystic adenohypophysitis. Bilateral optic neuritis also occurred and the pattern visual evoked cortical potential (VECP) demonstrated increased P100 peak latency and reduction of amplitude. After steroid pulse therapy, the visual acuity and field improved and the pattern VECP became normal. Temporal hemianopia was not noted. A direct infiltration of the inflammatory change in the pituitary gland or some autoimmune problem was considered as a cause of the optic neuritis. In contrast to the VECPs of multiple sclerosis patients, the prolonged peak latency of pattern VECPs of this case were shortened in accordance with the recovery of visual acuity.