Diagnosis and treatment of autoimmune and IgG4-related hypophysitis: clinical guidelines of the Japan Endocrine Society

Endocr J. 2020 Apr 28;67(4):373-378. doi: 10.1507/endocrj.EJ19-0569. Epub 2020 Mar 7.

Abstract

Hypophysitis, which is often accompanied by pituitary dysfunction, is classified into several subtypes based on the cause, histology, and the location of inflammation in the pituitary gland. A definitive diagnosis requires pituitary biopsy, which is invasive, and the process is limited to specialized clinical settings. In this opinion paper, we review the literature associated with hypophysitis, and provide the guidelines of the Japan Endocrine Society for the diagnosis and treatment of autoimmune and IgG4-related hypophysitis.

Keywords: Autoimmunity; Diabetes insipidus; Hypopituitarism; IgG4; Pituitary.

Publication types

  • Practice Guideline

MeSH terms

  • Autoimmune Hypophysitis / complications
  • Autoimmune Hypophysitis / diagnosis*
  • Autoimmune Hypophysitis / metabolism
  • Autoimmune Hypophysitis / therapy
  • Decompression, Surgical / methods
  • Endocrinology
  • Glucocorticoids / therapeutic use*
  • Headache / etiology
  • Hormone Replacement Therapy / methods
  • Humans
  • Hypopituitarism / drug therapy*
  • Hypopituitarism / etiology
  • Hypopituitarism / metabolism
  • Japan
  • Magnetic Resonance Imaging
  • Neurosurgical Procedures / methods*
  • Societies, Medical
  • Vision Disorders / etiology
  • Visual Fields

Substances

  • Glucocorticoids