[Current update on hypophysitis]

Rev Med Interne. 2014 Dec;35(12):815-22. doi: 10.1016/j.revmed.2014.05.020. Epub 2014 Aug 7.
[Article in French]

Abstract

Hypophysitis is a rare disorder. As clinical manifestations and radiologic signs are non specific, the diagnosis is difficult. Pathogenesis of hypophysitis remains largely unknown but new histological and etiological variants have been recently reported. Primary hypophysitis is the main form. For the first time, hypophysitis in ANCA-associated vasculitides has been reported. An entity of IgG4 related plasmatic hypophysitis has been described and well-defined diagnostic criteria have been proposed. Monoclonal antibodies directed against the cytotoxic T-lymphocyte antigen-4 (CTLA-4), investigated in metastatic cancer, can induce hypophysitis. Several candidate pituitary auto-antigens have been described in the last decade, although none has proven to be useful as a diagnostic tool.

Keywords: Anti-CTLA-4 antibody; Anticorps monoclaux anti-CTLA-4; Autoantigène hypophysaire; Corticosteroids; Corticoïdes; Hypophysite; Hypophysite par infiltration d’IgG4; Hypophysitis; IgG4 related hypophysitis; Pituitary auto-antigens.

Publication types

  • English Abstract
  • Review

MeSH terms

  • CTLA-4 Antigen / immunology
  • Diagnosis, Differential
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunoglobulin G / blood
  • Immunosuppressive Agents / adverse effects
  • Inflammation / diagnosis*
  • Inflammation / etiology
  • Inflammation / immunology
  • Inflammation / therapy*
  • Magnetic Resonance Imaging
  • Pituitary Diseases / diagnosis*
  • Pituitary Diseases / etiology
  • Pituitary Diseases / immunology
  • Pituitary Diseases / therapy*

Substances

  • CTLA-4 Antigen
  • Glucocorticoids
  • Immunoglobulin G
  • Immunosuppressive Agents