Hypophysitis: a single-center case series

Imber, Brandon S.; Lee, Han S.; Kunwar, Sandeep; Blevins, Lewis S.; Aghi, Manish K.

doi:10.1007/s11102-014-0622-5

Cited by 62 publications

(62 citation statements)

References 62 publications

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“…We found that 65% (90/139) of patients with GTR had headache improvement, higher than the 51% (73/142) of patients with subtotal resection who had headache improvement (P = 0.03). One example of the role of lesional resolution in headache improvement was how none of the five hypophysitis cases with headache had resolution after surgery, which were all biopsies, but four of five improved after a prolonged postoperative course of steroids led to lesional resolution on imaging, as we have described previously [20]. While headache improved more rapidly in patients with headache as a chief complaint (greater improvement at 6 weeks and 6 months, P < 0.05), the long-term improvement rate after 6 months was comparable in the two groups (P > 0.05).…”

Section: Factors Predicting Headache Improvementmentioning

confidence: 57%

Incidence of headache as a presenting complaint in over 1000 patients with sellar lesions and factors predicting postoperative improvement

Jahangiri

Wagner

Chin

et al. 2015

Clinical Neurology and Neurosurgery

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Section: Factors Predicting Headache Improvementmentioning

confidence: 57%

Incidence of headache as a presenting complaint in over 1000 patients with sellar lesions and factors predicting postoperative improvement

Jahangiri

Wagner

Chin

et al. 2015

Clinical Neurology and Neurosurgery

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“…Recently, an increasing number of clinical studies and patient series have been published [3,5,15,16] . To our knowledge, our paper for the first time describes a series of patients diagnosed with primary autoimmune hypophysitis at a single center in a prospective view.…”

Section: Discussionmentioning

confidence: 99%

“…In most of the recent reports, the frequency of females with primary autoimmune hypophysitis varied from 51.6 to 87.5% [3,[5][6][7][8][9][10][11][12][13][14][15] . In our series, hypophysitis occurred more frequently in female patients, who represented 81% of the cases, with a femaleto-male ratio of approximately 4.3: 1.…”

Section: Discussionmentioning

confidence: 99%

“…Autoimmune hypophysitis typically presents as a sella turcica mass with four variable categories of symptoms: (1) symptoms of sellar compression, such as headaches and visual field impairment, (2) hypopituitarism, (3) diabetes insipidus, and (4) hyperprolactinemia [2] . Pituitary biopsy is considered the best diagnostic method, with histopathological sample examination and the detection of lymphocytes within the pituitary gland [3] . However, this procedure is usually not indicated in patients who do not have a mass effect, as there could be potential adverse events such as further deterioration of pituitary function.…”

Section: Introductionmentioning

confidence: 99%

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An Overview of Diagnosis of Primary Autoimmune Hypophysitis in a Prospective Single-Center Experience

Chiloiro¹,

Tartaglione

Angelini

et al. 2016

Neuroendocrinology

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Background: Autoimmune hypophysitis is a rare disease with a natural progression that is not well known. Aim: To collect representative data on clinical features of autoimmune hypophysitis and better characterize the disease. Patients and Methods: A prospective single-center study was designed. Autoimmune hypophysitis-affected patients evaluated from 2011 at our tertiary care Pituitary Unit were enrolled. After ruling out other pituitary masses and secondary causes of hypophysitis, autoimmune hypophysitis was the diagnosis of exclusion. Autoimmune hypophysitis was classified as adenohypophysitis, panhypophysitis, and infundibuloneurohypophysitis according to clinical and neuroradiological findings. Results: A total of 21 patients met the inclusion criteria: 9 were diagnosed with adenohypophysitis, 4 with panhypophysitis, and 8 with infundibuloneurohypophysitis. The frequency of secondary hypoadrenalism was similar in adenohypophysitis, panhypophysitis, and infundibuloneurohypophysitis. Growth hormone deficit and secondary hypogonadism occurred more frequently in infundibuloneurohypophysitis than in adenohypophysitis and panhypophysitis (p = 0.009; p = 0.04). All cases of multiple pituitary secretion deficits occurred in cases of infundibuloneurohypophysitis (p = 0.04). No correlations between hypophysitis subtype and anti-pituitary and anti-hypothalamus autoantibodies were found. A higher frequency of extractable nuclear antigens (ENA) and anti-nuclear antibodies (ANA) was found in cases of panhypophysitis (OR 5.0, 95% CI 0.86-28.8, p < 0.001, and OR 1.8, 95% CI 1.1-3.2, p = 0.02, respectively) as compared to adenohypophysitis and infundibuloneurohypophysitis. Conclusion: Infundibuloneurohypophysitis should be taken into account in the etiological diagnosis of hypopituitarism, particularly if it is associated with diabetes insipidus and in cases of growth hormone deficit, secondary hypogonadism, or multiple hormone deficits. Contrast-enhanced MRI is crucial for the clinical and noninvasive diagnosis of hypophysitis. Screening for autoantibodies, particularly anti-ENA and anti-ANA, is strongly suggested in the clinical context of hypophysitis.

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“…The diagnosis is confirmed by histopathology and detection of pituitary antibodies (Abs) in patients with isolated or multiple pituitary hormone deficiencies [4] . However, in most cases diagnosis is usually based on endocrinological and radiological findings in the relevant clinical setting [10,11] .…”

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confidence: 99%

New Molecular, Biological, and Immunological Agents Inducing Hypophysitis

Angelousi

Chatzellis²,

Kaltsas³

2017

Neuroendocrinology

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b 251 HAF and VA Hospital, Athens , Greece thus its true prevalence is probably underestimated. The pathophysiology of hypophysitis induced by anticancer agents is not fully clarified. In most cases, treatment requires dose adjustment of the offending drug and pituitary hormone replacement. This mini-review aims to present currently available information regarding hypophysitis related to new molecular, biological, and immunological agents.

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Hypophysitis: a single-center case series

Abstract: Hypophysitis is an increasingly recognized diagnosis that can present with a broad array of radiographic and clinical features. Surgical biopsy can be helpful to make definitive diagnosis and may guide treatment decision-making.

Cited by 62 publications

References 62 publications

Incidence of headache as a presenting complaint in over 1000 patients with sellar lesions and factors predicting postoperative improvement

Incidence of headache as a presenting complaint in over 1000 patients with sellar lesions and factors predicting postoperative improvement

An Overview of Diagnosis of Primary Autoimmune Hypophysitis in a Prospective Single-Center Experience

New Molecular, Biological, and Immunological Agents Inducing Hypophysitis

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