Hypophysitis identified on initial presentation of systemic lupus erythematosus: a case report and review of the literature

Yoshihara, Risa; Tsuchiya, Haruka; Tsuzuki, Sayaka; Harada, Hiroaki; Shoda, Hirofumi; Fujio, Keishi

doi:10.1080/03009742.2020.1861648

Cited by 1 publication

(1 citation statement)

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“…Meanwhile, we searched Pubmed and Wanfang database using the terms "SLE and hypophysitis, pituitary dysfunction, pituitary insufficiency, pituitary abnormality, pituitary enlargement, or diabetes insipidus" from 1995 to 2021, and eight patients with complete information were selected. [4][5][6][7][8][9][10][11] The eight patients and our two patients made a group of ten patients of SLE-H, which we compared with our four hypophysitis with IgG4RD (IgG4-H). All patients on GCs and other immunosuppressants signed informed consents; an ethics committee was not needed for such retrospective analysis.…”

Section: Study Subjectsmentioning

confidence: 99%

Clinical characteristics of rheumatic disease-associated hypophysitis: A case series and review of literature

Yan

Jin

et al. 2022

Medicine

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Rheumatic diseases have been reported to sometimes involve the pituitary gland. This study aims to characterize the clinical features and outcomes of patients with rheumatic disease-associated hypophysitis. We used the electronic medical record system in our hospital to identify nine patients with pituitary involvement in rheumatoid disease. We summarized the clinical characteristics, radiographic findings, treatments, and clinical outcomes of the 9 patients. We also performed a systematic literature review of systemic lupus erythematosus (SLE) cases with pituitary involvement published in PubMed and Wanfang databases from 1995 to 2021, and eight patients with complete information were selected. In the nine-patient cohort, the median age was 54 years, and the spectrum of rheumatic diseases included immunoglobulin G4-related disease (IgG4RD) (4/9), SLE (2/9), vasculitis (2/9), and Sjögren syndrome (SS) (1/9). All patients had pituitary abnormalities on radiological assessment, 6 developed diabetes insipidus (DI), and 8 presented with anterior pituitary hormone deficiencies in the disease duration. All the patients had multisystem involvement. As compared to hypophysitis with IgG4RD (IgG4-H), the age at onset of hypophysitis with SLE (SLE-H) patients was younger [(30.4 ± 16.4) years vs. (56.0 ± 0.8) years] and the disease duration was shorter [(14.0 ± 17.5) months vs. (71.0 ± 60.9) months] (P < .05). All patients were managed with glucocorticoids (GC) in combination with another immunosuppressant, and the majority of patients improved within 4 months. Six patients achieved disease remission while four required at least one hormone replacement therapy. Hypophysitis is a rare complication secondary to a variety of various rheumatic diseases that can occur at any stage. GC combined with additional immunosuppressants could improve patients' symptoms; however some patients also required long-term hormone replacement therapy in pituitary disorders.

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