Related Experiment Video
Updated: Jun 12, 2025
Preparation of Mouse Pituitary Immunogen for the Induction of Experimental Autoimmune Hypophysitis
Published on: December 17, 2010
Deciphering the Presentation and Etiologies of Hypophysitis Highlights the Need for Repeated Systematical
Lea Miquel1, Benoit Testud2, Frederique Albarel3
1Service de Médecine Interne et d'Immunologie Clinique, Hôpital de La Conception, Assistance Publique Hôpitaux de Marseille (AP-HM), 13005 Marseille, France.
Context:
Hypophysitis is defined as an inflammation of the pituitary gland and/or infundibulum.
Objective:
Our aim was to characterize the initial course and evolution of patients with hypophysitis according to the different etiologies.
Methods:
Retrospective observational study conducted in a university referral hospital center. Patients over 15 years of age were included if they had a diagnosis of hypophysitis between January 2014 and October 2023, with the exclusion of hypophysitis secondary to immune checkpoint inhibitors.
Results:
Sixty-one patients (64% women; median age, 34 years) were included. Polyuria-polydipsia, headache, and asthenia were present in 64%, 48%, and 44% of cases respectively. At diagnosis, at least 1 anterior pituitary deficiency was present in 91.5% of cases and vasopressin deficiency in 56%. Magnetic resonance imaging was abnormal in 97% of cases. Secondary hypophysitis was found in 46% of cases (n = 28), including sarcoidosis in 28% (n = 17) and L (Langerhans) group histiocytoses in 13.1% (n = 8). Among patients with secondary hypophysitis, pituitary deficiency preceded systemic manifestations in 23% and occurred concomitantly in 23% of cases. Patients were treated in 36% of cases (glucocorticoids, surgery), without improvement of pituitary hormone deficits.
Conclusion:
A systemic etiology of hypophysitis was found in almost half of the patients. Pituitary disorders preceded the systemic disease in a quarter of the cases. This emphasizes the importance of a systematic repeated workup looking for a secondary etiology of hypophysitis in these patients.
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