The course of lymphocytic hypophysitis

Bitton, Rachelle N.; Slavin, Michael L.; Decker, Robert De; Zito, Joseph; Schneider, B

doi:10.1016/0090-3019(91)90131-r

Cited by 55 publications

(17 citation statements)

References 7 publications

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“…Transsphenoidal surgery is, however, both diagnostic and therapeutic and, therefore, should be performed in cases with progressive compression or those in whom radiographical and/or clinical progression occurs during conservative medical management (1,31,32). Hyperprolactinemia (33)(34)(35) and pituitary insufficiency (36,37) resolve after pituitary surgery, in most cases (1). In rare instances, surgical intervention has resulted in further deterioration of visual field deficits (38) and/or hypopituitarism (33, 38 -40).…”

Section: Discussionmentioning

confidence: 99%

“…Spontaneous recovery of pituitary function with resolution of the pituitary mass has been described in cases with histologically proven hypophysitis (36,37,42,43). Some patients, however, require active treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, lack of tumor shrinkage, as in our cases, should raise the suspicion of hypophysitis. Glucocorticoid therapy has been advocated to reduce inflammation and has been temporarily effective in some patients (35,37,39). The true efficacy of corticosteroid therapy in this condition, however, also remains uncertain.…”

Section: Discussionmentioning

confidence: 99%

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The Spectrum and Significance of Primary Hypophysitis

Cheung

Ezzat²,

Smyth

et al. 2001

The Journal of Clinical Endocrinology &Amp; Metabolism

162

119

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Hypophysitis can present clinically as a mass lesion of the sella turcica. Secondary hypophysitis occurs in cases where a definite etiologic agent or process inciting the inflammatory reaction can be identified. In contrast, primary hypophysitis refers to inflammation confined to the pituitary gland with no identifiable etiologic associations. We report three cases of primary hypophysitis to illustrate the spectrum of three clinicopathological entities that encompass this disease: lymphocytic hypophysitis, granulomatous hypophysitis, and xanthomatous hypophysitis. Our three patients underwent surgery, with variable response. However, conservative, supportive treatment with or without surgical decompression is generally favored over aggressive and extensive surgical resection that results in hypopituitarism. We conclude that the optimal management of patients with hyophysitis requires a high index of suspicion before extensive surgical resection. Histological confirmation of the diagnosis of hypophysitis can be obtained by performing a biopsy or by requesting an intraoperative frozen section consultation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Spectrum and Significance of Primary Hypophysitis

Cheung

Ezzat²,

Smyth

et al. 2001

The Journal of Clinical Endocrinology &Amp; Metabolism

162

119

View full text Add to dashboard Cite

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“…Spontaneous disappearence has been observed occasionally [6,7,11,18,30,36]. Anti-in¯ammatory therapy with oral steroids has been tried with either no eect or temporary improvement with relapse after discontinuation of the medication [2, 28, 31, 32, 34, 36].…”

Section: Discussionmentioning

confidence: 99%

Lymphocytic hypophysitis presenting with diabetes insipidus in a 14-year-old girl: case report and review of the literature

Cemeroğlu

Blaivas²,

Muraszko³

et al. 1997

European Journal of Pediatrics

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We present the first childhood case of lymphocytic hypophysitis which is an autoimmune inflammatory disorder of the pituitary gland. Although this is a rare condition in adults, it also needs to be considered in the pediatric population. Conservative management is preferred unless there are signs of increased intracranial pressure. Most importantly, close monitoring for multiple hormone deficiencies is indicated in this condition.

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“…As the present case had severe impotence, testosterone as well as glucocorticoid and thyroid hormone has been replaced. Corticosteroid therapy has been advocated to reduce inflammation and has been effective in some patients [6,25,26], but in other reported instances, no benefit was achieved [27,28] . In the present case, although pituitary hormone levels were not changed, glucocorticoid therapy seemed to be effective as shrinkage of the pituitary stalk was seen one month after the start of treatment.…”

Section: Anti Pituitary Antibodiesmentioning

confidence: 99%

A Case of Lymphocytic Infundibuloneurohypophysitis Showing Diabetes Insipidus Followed by Anterior Hypopituitarism Associated with Thrombasthenia.

et al. 2000

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Abstract.We report a case of a 42-year old male patient with diabetes insipidus followed by anterior hypopituitarism associated with thrombasthenia.The patient had been diagnosed with thrombasthenia since the age of 19. He was admitted and diagnosed as diabetes insipidus in 1995. Although T1-weighted image of magnetic resonance imaging (MRI) showed empty sella and partial pituitary stalk hypertrophy, the anterior pituitary functions were normal at that time. Three years later, he was re-admitted after an episode of general malaise and impotence in 1998. Endocrinological studies revealed adrenal insufficiency, hypothyroidism and hypogonadism.T1-weighted image of MRI demonstrated the thickening of pituitary stalk and neurohypophysis.Analysis of anti-pituitary antibodies by immunoblotting identified a major band at 61.5 kDa. The diabetes insipidus was controlled by desmopressin acetate and the shrinkage of pituitary stalk was seen after hormonal replacement therapy including glucocorticoid and thyroid hormone.We suggested that this case represented lymphocytic infundibuloneurohypophysitis, in which a chronic inflammatory process occurred in infundibulum and/or neurohypophysis and that hypopituitarism developed possibly due to damage to the pituitary portal vessels caused by a thickened pituitary stalk, although a pituitary biopsy was not done because of the risk of bleeding in thrombasthenia.The pituitary autoantibodies in sera from patients with hypopituitarism may be helpful to characterize the patient with lymphocytic hypophysitis.

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The course of lymphocytic hypophysitis

Cited by 55 publications

References 7 publications

The Spectrum and Significance of Primary Hypophysitis

The Spectrum and Significance of Primary Hypophysitis

Lymphocytic hypophysitis presenting with diabetes insipidus in a 14-year-old girl: case report and review of the literature

A Case of Lymphocytic Infundibuloneurohypophysitis Showing Diabetes Insipidus Followed by Anterior Hypopituitarism Associated with Thrombasthenia.

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