Recurrent autoimmune hypophysitis treated with rituximab: a case report

Kruse, María Sol; Olesen, Thomas Bastholm; Marković, Ljubo; Glintborg, Dorte; Andersen, Marianne

doi:10.1186/s13256-021-03146-0

Cited by 7 publications

(3 citation statements)

References 24 publications

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“…Based on a meta-analysis of 17 studies, 36% of lymphocytic hypophysitis patients were treated with steroids while 34% were treated surgically [ 13 ]. Other alternative treatments are immunosuppressive medications and radiosurgery with radiotherapy [ 14 ]. Prognosis after treatment is variable, although most patients will need to take long-term hormone replacement due to the resection from surgery or recurrence of hypophysitis [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Unique case of lymphocytic hypophysitis with normal pituitary hormone serology mimicking a non-functioning pituitary adenoma

Shen,

Cadang,

Phillips

et al. 2024

BMC Endocr Disord

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Background Lymphocytic hypophysitis is a rare autoimmune condition that usually presents during pregnancy and causes inflammation of the pituitary gland. Although the pathophysiology is not well understood, it often presents with headaches, visual disturbances, and symptoms of hypopituitarism. However, not all cases may present with hypopituitarism which can make this rare disease with an incidence of ~ 1 in 9 million much more difficult to diagnose. Case Presentation We present a 35-year-old G4P4 woman with progressive vision loss and intermittent frontal headaches during her first trimester through 2 months postpartum. She presented with no symptoms of hypopituitarism and her hormone panel only showed elevated prolactin, possibly due to her breastfeeding. She was treated with a right pterional craniotomy with decompression of both optic nerves, partial resection of the suprasellar mass, and glucocorticoid therapy for headaches and visual disturbances. Conclusion This case is notable for a presentation of lymphocytic hypophysitis without symptoms of hypopituitarism. This is important for outpatient providers to be aware of, especially those that care for pregnant patients so that unfavorable outcomes can be avoided.

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Section: Discussionmentioning

confidence: 99%

Unique case of lymphocytic hypophysitis with normal pituitary hormone serology mimicking a non-functioning pituitary adenoma

Shen,

Cadang,

Phillips

et al. 2024

BMC Endocr Disord

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“…AH [ 1 ] is a rare disease with an incidence of one in nine million/year [ 4 , 5 ] according to published studies. Since the first description by Goudie and Pinkerton [ 6 ] of lymphocytic AH in 1962, hundreds of cases have been recognized as per a recent meta-analysis.…”

Section: Discussionmentioning

confidence: 99%

A Rare Association of Autoimmune Hypophysitis With Seronegative Rheumatoid Arthritis: A Case Report

Kamran,

Ghazy,

Misakyan

et al. 2024

Cureus

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Autoimmune hypophysitis (AH) is an uncommon condition where there is inflammation of the pituitary gland which leads to hormonal imbalances. It is often associated with autoimmune diseases; however, a case is yet to be reported with an association of AH with seronegative rheumatoid arthritis (RA). We present a case of a 45-year-old female who complained of polyuria/polydipsia and rapid weight gain. An MRI of the head revealed enlargement of the pituitary gland, concerning for AH. Although she was initially treated for diabetes insipidus, she began reporting new complaints of joint pains and morning stiffness. She was clinically diagnosed with seronegative RA and improved with a trial of hydroxychloroquine. A repeat MRI showed improvement in the abnormal pituitary findings, and the patient was closely monitored with a multidisciplinary approach. Diagnosing and managing patients with AH are topics that are still being explored and researched as it is a relatively rare pathology. Consequently, we found the need to discuss the relationship of AH with seronegative RA and delve into the various diagnostic and treatment approaches.

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“…Methotrexate, cyclosporine, infliximab, gamma knife, stereotactic radiosurgery, and rituximab are other options that have successfully treated hypophysitis [ 14 , 20 , 26 ]. Rituximab might be an effective alternative treatment in B cell-predominant autoimmune hypophysitis [ 49 ].…”

Section: Diagnosismentioning

confidence: 99%

Hypophysitis: Defining Histopathologic Variants and a Review of Emerging Clinical Causative Entities

Rawanduzy

Winkler-Schwartz

Couldwell

2023

IJMS

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Inflammatory disease of the pituitary gland is known as hypophysitis. There are multiple histological subtypes, the most common being lymphocytic, and the pathogenesis is variable and diverse. Hypophysitis can be primary and idiopathic or autoimmune related, or secondary to local lesions, systemic disease, medications, and more. Although hypophysitis was previously accepted as an exceedingly rare diagnosis, a greater understanding of the disease process and new insights into possible etiologic sources have contributed to an increased frequency of recognition. This review provides an overview of hypophysitis, its causes, and detection strategies and management.

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Recurrent autoimmune hypophysitis treated with rituximab: a case report

Cited by 7 publications

References 24 publications

Unique case of lymphocytic hypophysitis with normal pituitary hormone serology mimicking a non-functioning pituitary adenoma

Unique case of lymphocytic hypophysitis with normal pituitary hormone serology mimicking a non-functioning pituitary adenoma

A Rare Association of Autoimmune Hypophysitis With Seronegative Rheumatoid Arthritis: A Case Report

Hypophysitis: Defining Histopathologic Variants and a Review of Emerging Clinical Causative Entities

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