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Induction of Experimental Autoimmune Hypophysitis in SJL Mice
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Neuro-radiological features can predict hypopituitarism in primary autoimmune hypophysitis
Tommaso Tartaglione1, Sabrina Chiloiro2, Maria Elena Laino1
1Institute of Radiology, School of Medicine, Catholic University of the Sacred Heart, Rome, Italy.
Pituitary
|May 13, 2018
Summary
Primary autoimmune hypophysitis (PAH) classification based on neuro-radiological signs can predict pituitary dysfunction. Specific features like pituitary stalk shape and bright spot loss indicate prognosis for radiological outcomes.
Area of Science:
- Endocrinology
- Radiology
- Immunology
Background:
- Primary autoimmune hypophysitis (PAH) is challenging to diagnose, often relying on exclusion.
- Neuro-radiological findings are crucial for understanding PAH subtypes and their clinical impact.
Purpose of the Study:
- To correlate neuro-radiological signs of PAH with endocrine dysfunctions.
- To evaluate the prognostic value of these radiological features for disease outcome.
Main Methods:
- Retrospective analysis of 24 PAH cases classified into adeno-hypophysitis (AHs), infundibulo-neuro-hypophysitis (INHs), and pan-hypophysitis (PHs).
- Correlation of radiological features (pituitary stalk shape, bright spot on T1w images) with endocrine deficits (hypogonadism, diabetes insipidus, GHD).
- Assessment of radiological improvement at 1-year follow-up and its correlation with specific imaging markers.
Main Results:
- INHs showed higher rates of secondary hypogonadism, diabetes insipidus, and GHD compared to AHs.
- PHs also presented with increased diabetes insipidus compared to AHs.
- Pituitary stalk pseudo-triangular shape correlated with GHD and diabetes insipidus. Loss of the neuro-pituitary bright spot and a larger pituitary stalk diameter (>4.1 mm) predicted radiological improvement.
Conclusions:
- Neuro-radiological classification of PAH (AH, INH, PH) aids in predicting pituitary dysfunction.
- Pituitary stalk diameter and the presence/loss of the neuro-pituitary bright spot are valuable prognostic markers for radiological recovery in PAH.
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