关键词: IgG4-related disease IgG4-related hypophysitis autoimmune hypophysitis immune checkpoint inhibitor ipilimumab

Mesh : Autoimmune Hypophysitis / diagnosis immunology therapy Glucocorticoids / therapeutic use Humans Hypophysitis / diagnosis epidemiology etiology therapy Hypopituitarism / diagnosis etiology therapy Immunoglobulin G / adverse effects blood Inflammation / complications diagnosis therapy Pituitary Diseases / complications diagnosis therapy Pituitary Gland / immunology metabolism

来  源:   DOI:10.1016/j.beem.2019.04.010   PDF(Sci-hub)

Abstract:
Hypophysitis is a rare entity characterized by inflammation of the pituitary gland and its stalk that can cause hypopituitarism and/or mass effect. Etiology can be categorized as primary or secondary to systemic disease, but may also be classified according to anatomical and hispathological criteria. Newly recognized causes of hypophysits have been described, mainly secondary to immunomodulatory medications and IgG4-related disease. Diagnosis is based on clinical, laboratory and imaging data, whereas pituitary biopsy, though rarely indicated, may provide a definitive histological diagnosis. For the clinician, obtaining a broad clinical and drug history, and performing a thorough physical examination is essential. Management of hypophysitis includes hormone replacement therapy if hypopituitarism is present and control of the consequences of the inflammatory pituitary mass (e.g. compression of the optic chiasm) using high-dose glucocorticoids, whereas pituitary surgery is reserved for those unresponsive to medical therapy and/or have progressive disease. However, there remains an unmet need for controlled studies to inform clinical practice.
摘要:
暂无翻译
公众号