Autoimmune Hypophysitis

Abstract

Autoimmune (lymphocytic) hypophysitis is a rare disease that should be considered in the differential diagnosis of any nonsecreting pituitary mass, especially when occurring during pregnancy or postpartum. We have analyzed 370 articles published from January 1962 to October 2004 and identified a total of 379 patients with primary lymphocytic hypophysitis. The present review synthesizes the clinical and research data reported in this body of scientific literature.

Incidence of primary cancers and intracranial tumour recurrences in GH-treated and untreated adult hypopituitary patients: analyses from the Hypopituitary Control and Complications Study

“…Details of all of the Japanese patients have been described previously (42); four of the ten patients had received GH treatment for !1 year, and one had received cranial irradiation that was strongly suspected to be the cause of the glioblastoma. One Japanese patient, described in that publication with unknown malignancy status, had reported onset of germinoma 0.6 years after initiation of GH therapy for GHD caused by autoimmune hypophysitis; cases of hypophysitis preceding or masking diagnosis of germinoma have been described (43). Sensitivity analyses that incorporated cases of uncertain malignant status were performed for all-site cancers.…”

Pituitary stalk thickening: the role of an innovative MRI imaging analysis which may assist in determining clinical management

“…Pituitary stalk lesions are often discovered on MRI either incidentally or during evaluation for symptoms related to various degrees of hypothalamic and/or pituitary dysfunction, especially in patients with isolated diabetes insipidus (DI). The differential diagnosis of masses affecting the pituitary stalk is wide, and can be grouped into three categories: congenital, inflammatory/infectious and neoplastic (8,10,11,12). However, to obtain a definitive histological diagnosis would require biopsy of the stalk, which is a difficult procedure associated with considerable morbidity (13).…”

Serum pituitary antibodies in normal pregnancy and in patients with postpartum thyroiditis: a nested case–control study

“…Caturegli et al reported that 120 out of 210 women (57%) presented AH during pregnancy or in postpartum. During pregnancy the pituitary gland increases its dimension and modifies the pattern of pituitary blood flow, possibly yielding it more prone to modifications of the immune system (17). A recent study proposed as a novel pituitary antigen, a protein sequence shared among GH1, which is mainly expressed in the pituitary, and the somatomammotropin-1 and -2 which are expressed in the placenta.…”

“…In a comprehensive review of 379 cases of AH, Caturegli et al showed that 120 out of the 210 women with AH were diagnosed during pregnancy or in the postpartum. Interestingly, the majority of patients presented symptoms of AH in the last months of pregnancy and in the first few months after delivery (17)(18)(19).…”