Primary and Ipilimumab-induced Hypophysitis: A Single-center Case Series

Area of Science:

• Endocrinology
• Neuroscience

Background:

• Hypophysitis is inflammation of the pituitary gland.
• It can be primary or secondary to immunotherapy.
• Understanding its presentation and management is crucial.

Purpose of the Study:

• To describe a case series of primary and immunotherapy-related hypophysitis.
• To analyze clinical presentation, management, and outcomes.

Main Methods:

• Retrospective chart review at a single center.
• Included 11 primary and 2 immunotherapy-related hypophysitis cases.
• Clinical diagnosis without biopsy in some primary cases.

Main Results:

• Headache and stalk enlargement were common in primary hypophysitis.
• Pituitary deficiencies (adrenal, thyroid, diabetes insipidus) were frequent.
• Primary hypophysitis masses resolved, but pituitary dysfunction persisted; immunotherapy-related cases also resolved with persistent dysfunction.

Conclusions:

• Primary hypophysitis masses typically resolve, with persistent hypopituitarism.
• Conservative management is recommended for primary hypophysitis without severe deficits.
• Immunotherapy-related hypophysitis can be managed effectively without supraphysiologic steroids if severe features are absent.