Immunological and clinical aspects of lymphocytic hypophysitis

Bellis, Annamaria De; Ruocco, Giuseppe; Battaglia, Marina; Conte, Maddalena; Coronella, Concetta; Tirelli, Gilda; Bellastella, Antonio; Pane, Elena; Sinisi, Antonio Agostino; Bizzarro, Antonio; Bellastella, Giuseppe

doi:10.1042/cs20070051

Cited by 44 publications

(20 citation statements)

References 70 publications

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“…It frequently affects women in last six months of pregnancy and in the first six months after delivery. 5 Symptoms of seller compression as headache and visual disturbances are the most common and usually the initial presenting complaints. Headache is found in 60% of patients and considered due to distension and distortion of the dura mater by the expanding pituitary mass.…”

Section: Resultsmentioning

confidence: 99%

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Lymphocytic hypophysitis presenting as a visual threatening sellar mass and its complete recovery with oral steroids: think beyond surgery

2013

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A 37-years female patient presented to us with hypothyroidism. She was started on oral thyroid replacement and sent back to home. Four weeks later she again came with history of progressive vision loss and headache. Ophthalmological evaluation revealed bitemporal hemianopia with bilateral papilloedema. Non-contrast computed tomography revealed mass lesion in pituitary fossa. Hormone profile showed secondary hypocortisolism and secondary hypothyroidism. Magnetic resonance imaging (MRI) brain showed diffusely enlarged sellar mass with suprasellar extension with enhancement of both anterior, posterior pituitary andinfundibulam. Neurologist advised urgent surgical intervention. A diagnosis of lymphocytic hypophysitis was made based on clinical and radiological evidences and surgery was deferred. Patient was given oral steroid on OPD basis and she improved dramatically. The mass also vanished subsequently on follow up MRI brain. This case illustrates the potential benefit of trial of medical management when there is a strong possibility even with vision loss due to mass effect in lymphocytic hypophysitis.

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Section: Resultsmentioning

confidence: 99%

“…5 Hormonal evaluation can also add in diagnosis. On histopathological examination, the adenohypophysis is infiltrated by lymphoplasmacytic cells consisting lymphocytes, plasma cells and macrophages.…”

Section: Resultsmentioning

confidence: 99%

Lymphocytic hypophysitis presenting as a visual threatening sellar mass and its complete recovery with oral steroids: think beyond surgery

2013

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“…11 Intracranial circulation depends on collateral circulation by the vertebrobasilar axis which, in our patient, developed due to chronic progressive invasion by the inflammatory process to both carotid arteries.…”

Section: Discussionmentioning

confidence: 99%

“…11,12 Other alternative therapies were not needed since no adverse effects were observed with corticosteroids.…”

Section: Discussionmentioning

confidence: 99%

A complicated case of primary hypophysitis with bilateral intracavernous carotid artery occlusion

Katsiveli

Sfakiotaki

Voulgaris

et al. 2016

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“…The discrepancy observed in different series is likely due to patient selection and the different methods used for APA determination (15,16).…”

Section: Introductionmentioning

confidence: 99%

Serum pituitary antibodies in normal pregnancy and in patients with postpartum thyroiditis: a nested case–control study

Manetti

Parkes²,

Lupi³

et al. 2008

European Journal of Endocrinology

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Objectives: The aim of this study was to evaluate antipituitary antibody (APA) prevalence in a series of patients with postpartum thyroiditis (PPT) during pregnancy and in the postpartum. Design: We conducted a nested case-control study on consecutive PPT and normal pregnant women at the Centre for Endocrine and Diabetes Sciences in Cardiff and at the Department of Endocrinology in Pisa. Methods: We enrolled 30 women with PPT: 17 were hypothyroid (Hypo), 7 with hyperthyroidism (Hyper) and 6 with a transient hyperthyroidism followed by hypothyroidism (Biphasic). Twenty-one healthy pregnant women served as controls. APA (measured using indirect immunofluorescence), free thyroxine, free triiodothyronine, TSH, antithyroid autoantibodies, and thyroid ultrasound were performed during pregnancy and postpartum. The stored sera have been sent to Pisa, where serum APA, IGF1, and cortisol were measured. Results: APA were found in 8 out of the 30 PPT patients (26.7%) and in one normal pregnancy (4.7%, PZ0.063). Three out of the seventeen Hypo with PPT (17.6%), three out of the seven Hyper PPT (42.8%), and two out of the six Biphasic PPT (33.3%) were positive for APA. APA prevalence was not significantly different in the PPT subgroups (PZ0.453). With one exception, APA all increased in the postpartum period (87.5%, P!0.016). Basal serum IGF1 and cortisol were in the normal range with the exception of two patients with positive APA who presented low serum IGF1 levels (36 and 45 ng/ml). Conclusions: APA are frequently present in the postpartum period in patients affected by PPT. Further studies are necessary to evaluate whether APA in PPT patients are associated with pituitary function impairment.European Journal of Endocrinology 159 805-809

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Immunological and clinical aspects of lymphocytic hypophysitis

Cited by 44 publications

References 70 publications

Lymphocytic hypophysitis presenting as a visual threatening sellar mass and its complete recovery with oral steroids: think beyond surgery

Lymphocytic hypophysitis presenting as a visual threatening sellar mass and its complete recovery with oral steroids: think beyond surgery

A complicated case of primary hypophysitis with bilateral intracavernous carotid artery occlusion

Serum pituitary antibodies in normal pregnancy and in patients with postpartum thyroiditis: a nested case–control study

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