What is a common clinical presentation of hypophysitis? Hypophysitis often presents as a mass lesion of the pituitary gland/stalk that simulates a pituitary adenoma, clinically and radiographically. Clinically, most patients present with headaches (> 70%), vision defects (> 40%), and variable degrees of anterior pituitary hormone deficiencies (50%–70%; most commonly gonadotroph (hypogonadism) > Corticotroph (adrenal …
What types of autoimmune disorders are associated with primary hypophysitis? Autoimmune diseases are associated with primary hypophysitis in approximately 20% to 25% of cases. Based on a large series of patients with primary hypophysitis (n = 376), the most commonly associated autoimmune diseases included: Hashimoto’s thyroiditis (7.4%), autoimmune polyglandular syndrome type 2 (1.8%), Graves’ disease …
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What are the main inflammatory and infectious causes of secondary hypophysitis? Secondary hypophysitis may be caused by an underlying systemic inflammatory disease, usually multivisceral, or an infectious disease that also involves the pituitary gland and/or stalk. The most common etiologies, and their characteristics, are shown in the below table. In addition, some sellar lesions (e.g., Rathke’s …
What are the main types of primary hypophysitis and their characteristics? Primary hypophysitis affects an estimated 1.9 million people in the United States and is considered an autoimmune disorder. It is subclassified by the primary inflammatory cell sub-type and includes the following main causes and characteristics: 1. Lymphocytic hypophysitis: The most common form of hypophysitis and is …
What is hypophysitis? Hypophysitis is an inflammatory condition resulting from infiltration of the pituitary gland and/or stalk. It can involve the anterior pituitary gland only (lymphocytic adenohypophysitis), the posterior pituitary gland and stalk (lymphocytic infundibuloneurohypophysitis), or both the anterior and posterior lobes (lymphocytic panhypophysitis). Hypophysitis can also be divided into primary and secondary etiologies.
What is pituitary stalk interruption syndrome? Pituitary stalk interruption syndrome (PSIS) is characterized by the association of an absent or thin pituitary stalk, an absent or hypoplastic anterior pituitary lobe, and/or an ectopic posterior pituitary lobe. PSIS is a frequent cause of congenital hypopituitarism (50% of cases). Patients with PSIS are usually diagnosed with hypoglycemia …
Main causes of pituitary stalk thickening The spectrum of pituitary diseases is diverse and includes lesions that arise from the pituitary stalk or from pituitary/hypothalamic–associated tumors. The four main causes of pituitary stalk abnormalities include: congenital, inflammatory, infectious, and neoplastic etiologies. The spectrum of pituitary stalk lesions differs between children and adults, and between those …