Executive summary of the consensus document on hypophysitis of the Neuroendocrinology Area of Knowledge of the Spanish Society of Endocrinology and Nutrition

Endocrinol Diabetes Nutr (Engl Ed). 2023 Mar:70 Suppl 1:116-125. doi: 10.1016/j.endien.2023.01.001. Epub 2023 Mar 7.

Abstract

The term hypophysitis is used to designate a heterogeneous group of pituitary conditions characterized by the presence of inflammatory infiltration of the adenohypophysis, neurohypophysis, or both. Although hypophysitis are rare disorders, the most common in clinical practice is lymphocytic hypophysitis, a primary hypophysitis characterized by lymphocytic infiltration, which predominantly affects women. Other forms of primary hypophysitis are associated with different autoimmune diseases. Hypophysitis can also be secondary to other disorders such as sellar and parasellar diseases, systemic diseases, paraneoplastic syndromes, infections, and drugs, including immune checkpoint inhibitors. The diagnostic evaluation should always include pituitary function tests and other analytical tests based on the suspected diagnosis. Pituitary magnetic resonance imaging is the investigation of choice for the morphological assessment of hypophysitis. Glucocorticoids are the mainstay of treatment for most symptomatic hypophysitis.

Keywords: Autoimmune; Autoinmune; Granulomatosa; Granulomatous; Hipofisitis; Hypophysitis; Immunotherapy; Infecciosa; Infectious; Infiltrativa; Infiltrative; Inmunoterapia; Linfocítica; Lymphocytic; Paraneoplastic; Paraneoplásica.

Publication types

  • Practice Guideline

MeSH terms

  • Autoimmune Hypophysitis* / complications
  • Autoimmune Hypophysitis* / diagnosis
  • Autoimmune Hypophysitis* / therapy
  • Consensus
  • Female
  • Humans
  • Hypophysitis* / complications
  • Hypophysitis* / diagnosis
  • Hypophysitis* / therapy
  • Neuroendocrinology
  • Pituitary Diseases* / diagnosis
  • Pituitary Diseases* / therapy
  • Pituitary Gland