Guía clínica de diagnóstico y tratamiento de las hipofisitis

Bauset, Miguel Català; Peral, Alberto Gilsanz; Borràs, Juan Girbés; Murillo, Ana Zugasti; Esteban, Basilio Moreno; Rabinovich, Irene Halperin; Alfonso, Gabriel Obiols; Alfonso, Antonio Picó; Picó, Carlos del Pozo; Moreno, Alfonso Soto; Vela, Enrique; Henzi, Frederic Tortosa; Morante, Tomás Lucas; Fernández, Concha Páramo; Ousa, César Varela da; Artero, Carles Villabona

doi:10.1016/s1575-0922(08)70634-x

Cited by 9 publications

(5 citation statements)

References 55 publications

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“…Similarly with pituitary haemorrhage or infarction, DI may be transient over a longer period 15 . With inflammatory pituitary or hypothalamic lesions, DI may fluctuate with periods of recovery and then recurrence 16 . This can make the final diagnosis more elusive as it possible that it may change after the diagnostic test has been performed.…”

Section: Discussionmentioning

confidence: 99%

Use of copeptin in interpretation of the water deprivation test

Rowe¹,

Patel²,

Jeffery

et al. 2023

Endocrino Diabet & Metabol

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Introduction Currently, the water deprivation test remains the standard method for distinguishing primary polydipsia (PP) from cranial diabetes insipidus (cDI) and nephrogenic diabetes insipidus (nDI). There is increasing interest in a direct estimate of antidiuretic hormone using plasma copeptin as a stable and reliable surrogate marker. We present our experience of measuring copeptin during the water deprivation test. Methods Forty‐seven people (17 men) underwent a standard water deprivation test between 2013 and 2021. Plasma copeptin was measured at the start of the test and at the end of the period of water deprivation (maximum osmotic stimulation). Results were classified using prespecified diagnostic criteria. As it is known that a significant proportion of tests will reveal indeterminate results, a final diagnosis was obtained by including relevant pre‐ and post‐test clinical criteria. This diagnosis was then used to plan individual treatment. Results Basal and stimulated copeptin were significantly higher in the nephrogenic DI group than other categories (p < .001). There was no significant difference in basal or stimulated copeptin between PP, cDI or partial DI. Nine results were indeterminate where the serum and urine osmolality did not give a unified diagnosis. Stimulated copeptin was helpful in reclassifying these patients into the final diagnostic groups. Conclusion Plasma copeptin has additional clinical utility in interpretation of the water deprivation test and may continue to have a place alongside newer stimulation tests.

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Section: Discussionmentioning

confidence: 99%

Use of copeptin in interpretation of the water deprivation test

Rowe¹,

Patel²,

Jeffery

et al. 2023

Endocrino Diabet & Metabol

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“…In most of the cases hyperprolactinemia [2] [4] is observed, due the compressive effect. However it is estimated that in up to 11% of cases inhibition of lactation can be found [1]. The following axis affected was the corticotropin, which is characteristic of hypophysitis.…”

Section: Discussionmentioning

confidence: 99%

“…In general, the lymphocytic hypophysitis is seen in women and is associated with the peri-and postpartum period. It is estimated an incidence of one case per nine million people, but probably, there are not diagnosticated subclinical forms [1]. Initially, the histopathology consists of a monoclonal lypmphocityc infiltrate which can leave minimal sequelae or progress to fibrosis.…”

Section: Introductionmentioning

confidence: 99%

A Case Report of Lymphocytic Hypophysitis Related to Pregnancy

Diego¹,

Ciudin²,

Simó‐Servat³

et al. 2015

OJEMD

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A 39-year-old woman consulted in the postpartum period because of agalactia, polyuria, polydipsia, and headache and decreased visual acuity. The initial analysis was compatible with a panhypopituitarism. The magnetic resonance (MRI) showed an expansive sellar and suprasellar lesion of high density in the basal study and enhancement after contrast administration, in contact with the optic chiasm, so urgent surgery was indicated. While waiting for the surgery, intravenous corticosteroids were initiated and the symptoms rapidly resolved. Most of the pituitary axes were recovered, except the diabetes insipidus. The control MRI showed complete resolution of the sellar mass. The surgery was canceled and the diagnosis of lymphocyte hypohpyisitis was made. Lymphocyte hypophysitis is an uncommon disease in which inflammation of the pituitary gland occurs. This results in a permanent or transient hormonal insufficiency. Lymphocyte hypophysitis is a very rare condition that occurs preferentially in women in the peripartum period. Early initiation of high doses of systemic corticosteroids may avoid unnecessary surgery in some cases.

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“…It mainly affects the anterior pituitary [ 5 ]. Adrenocorticotrophic hormone (ACTH) deficiency is common [ 16 ]. The proposed relationship between hypophysitis and pregnancy is related to pituitary hyperplasia during the gestational period increasing pituitary antigens and alterations in hypophyseal blood flow.…”

Section: Subvariantsmentioning

confidence: 99%

“…The histologic subtypes of primary hypophysitis are lymphocytic, granulomatous, xanthomatous, IgG4-related disease, and necrotizing hypophysitis [ 4 , 7 , 13 , 15 ]. The most common form is lymphocytic, followed by granulomatous hypophysitis [ 2 , 16 ]. Hypophysitis can radiologically mimic other nonfunctioning masses [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Hypophysitis: Defining Histopathologic Variants and a Review of Emerging Clinical Causative Entities

Rawanduzy

Winkler-Schwartz

Couldwell

2023

IJMS

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Inflammatory disease of the pituitary gland is known as hypophysitis. There are multiple histological subtypes, the most common being lymphocytic, and the pathogenesis is variable and diverse. Hypophysitis can be primary and idiopathic or autoimmune related, or secondary to local lesions, systemic disease, medications, and more. Although hypophysitis was previously accepted as an exceedingly rare diagnosis, a greater understanding of the disease process and new insights into possible etiologic sources have contributed to an increased frequency of recognition. This review provides an overview of hypophysitis, its causes, and detection strategies and management.

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Guía clínica de diagnóstico y tratamiento de las hipofisitis

Cited by 9 publications

References 55 publications

Use of copeptin in interpretation of the water deprivation test

Use of copeptin in interpretation of the water deprivation test

A Case Report of Lymphocytic Hypophysitis Related to Pregnancy

Hypophysitis: Defining Histopathologic Variants and a Review of Emerging Clinical Causative Entities

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