New causes of hypophysitis.

Department

Neuroendocrinology

Document Type

Article

Abstract

Hypophysitis is a rare entity characterized by inflammation of the pituitary gland and its stalk that can cause hypopituitarism and/or mass effect. Etiology can be categorized as primary or secondary to systemic disease, but may also be classified according to anatomical and hispathological criteria. Newly recognized causes of hypophysits have been described, mainly secondary to immunomodulatory medications and IgG4-related disease. Diagnosis is based on clinical, laboratory and imaging data, whereas pituitary biopsy, though rarely indicated, may provide a definitive histological diagnosis. For the clinician, obtaining a broad clinical and drug history, and performing a thorough physical examination is essential. Management of hypophysitis includes hormone replacement therapy if hypopituitarism is present and control of the consequences of the inflammatory pituitary mass (e.g. compression of the optic chiasm) using high-dose glucocorticoids, whereas pituitary surgery is reserved for those unresponsive to medical therapy and/or have progressive disease. However, there remains an unmet need for controlled studies to inform clinical practice.

Medical Subject Headings

Autoimmune Hypophysitis; Glucocorticoids; Humans; Hypophysitis; Hypopituitarism; Immunoglobulin G; Inflammation; Pituitary Diseases; Pituitary Gland

Publication Date

4-1-2019

Publication Title

Best practice & research. Clinical endocrinology & metabolism

ISSN

1878-1594

Volume

33

Issue

2

First Page

101276

Last Page

101276

PubMed ID

31078416

Digital Object Identifier (DOI)

10.1016/j.beem.2019.04.010

This document is currently not available here.

Share

COinS