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Diagnosis of Primary Hypophysitis in Germany
Jürgen Honegger1, Sven Schlaffer1, Christa Menzel1
1Department of Neurosurgery (J.H., M.M.), University of Tuebingen, 72076 Tuebingen, Germany; Department of Neurosurgery (S.Sc., C.M.), University of Erlangen-Nuremberg, 91054 Erlangen, Germany; Endocrine Practice (M.D., S.W.), 26122 Oldenburg, Germany; Department of Endocrinology, Diabetes, and Nutrition (U.E., C.S.), Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany; Department of Medicine IV (S.St., A.K.), Campus Innenstadt, University of Munich, 80336 Munich, Germany; Division of Endocrinology and Diabetes (C.S.v.d.W.), RWTH Aachen University, 52074 Aachen, Germany; Endocrine and Diabetes Unit (T.D.), Department of Medicine I, University Hospital Würzburg, 97080 Würzburg, Germany; Max Planck Institute of Psychiatry (M.S.), 80804 Munich, Germany; Department of Pituitary Surgery/Interdisciplinary Endocrinology (R.R.), UKE Hamburg, 20246 Hamburg, Germany; and ENDOC Center for Endocrine Tumors (S.P.), 20357 Hamburg, Germany.
Primary hypophysitis (PrHy) diagnosis is clarified, revealing hypogonadism as the most common endocrine failure, contrary to prior literature. Weight gain is a key clinical sign, suggesting non-invasive diagnosis is often possible.
Area of Science:
- Endocrinology
- Neuroendocrinology
- Oncology
Background:
- Diagnostic findings in primary hypophysitis (PrHy) are not well-represented in existing literature.
- Limited data exists on the clinical presentation and diagnostic work-up of PrHy.
Purpose of the Study:
- To gather consistent data on clinical features in a large cohort of PrHy patients.
- To investigate current practices in the diagnostic work-up for PrHy.
Main Methods:
- A nationwide retrospective cross-sectional cohort study was conducted in Germany.
- Seventy-six patients diagnosed with PrHy were identified and analyzed.
- Clinical, endocrinological, and neuroradiological features were assessed.
Main Results:
- Headache and weight gain were the most common non-endocrine symptoms.
- Hypogonadotropic hypogonadism (62%) was the most frequent endocrine failure, and pituitary stalk thickening (86%) was the predominant radiological finding.
- Granulomatous hypophysitis presented with more severe symptoms than lymphocytic hypophysitis.
Conclusions:
- Hypogonadism is the most frequent endocrine failure in PrHy, challenging previous reports.
- Weight gain is a significant clinical indicator of PrHy.
- Characteristic clinical signs and symptoms may obviate the need for histological confirmation in most PrHy cases, supporting a standardized diagnostic approach.
