| Title: |
DECIPHERING THE PRESENTATION AND ETIOLOGIES OF HYPOPHYSITIS HIGHLIGHTS THE NEED FOR REPEATED SYSTEMATICAL INVESTIGATIONS |
| Authors: |
Miquel, Léa; Testud, Benoit; Albarel, Frédérique; Sahakian, Nicolas; Cuny, Thomas; Graillon, Thomas; Brue, Thierry; Dufour, Henri; Schleinitz, Nicolas; Kaplanski, Gilles; Ebbo, Mikael; Castinetti, Frederic |
| Contributors: |
Marseille medical genetics - Centre de génétique médicale de Marseille (MMG); Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM); Institut Marseille Maladies Rares (MarMaRa); Aix Marseille Université (AMU); Service d'endocrinologie, diabète, maladies métaboliques Hôpital de la Conception - APHM |
| Source: |
ISSN: 0804-4643. |
| Publisher Information: |
CCSD; Oxford Univ. Press |
| Publication Year: |
2024 |
| Collection: |
Aix-Marseille Université: HAL |
| Subject Terms: |
hypophysitis; sarcoidosis; histiocytoses of the L group; corticotroph deficiency; [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology; [SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism |
| Description: |
International audience ; Aims: Hypophysitis is defined as an inflammation of the pituitary gland and/or infundibulum with possible clinical, radiological and hormonal consequences. The aim of this study was to characterize the initial course and evolution of patients with hypophysitis according to the different etiologies. Patients and methods: Retrospective observational study conducted in a universitary referral hospital center. Patients over 15 years of age were included if they had a diagnosis of hypophysitis between January 2014 and October 2023, defined according to clinical, biological and radiological criteria, with the exclusion of hypophysitis secondary to immune checkpoint inhibitors. Relevant data on diagnosis, outcome and treatment modalities were collected. Results: Sixty-one patients (64% women; median age, 34 years) were included. Polyuria-polydipsia, headache and asthenia were present in 64%, 48% and 44% of cases respectively. At diagnosis, at least one anterior pituitary deficiency was present in 91.5% of cases (gonadotroph 39%, corticotroph 29% and thyrotroph 26%) and vasopressin deficiency in 56%. MRI was abnormal in 97% of cases: loss of spontaneous posterior pituitary T1 hypersignal, thickening of the pituitary stalk, pituitary hyperplasia symmetrical pituitary enlargement, and extra-pituitary abnormalities were reported in 70%, 52%, 38%, and 25% of cases, respectively. Secondary hypophysitis was found in 46% of cases (n=28), including sarcoidosis in 28% (n=17) and L-group histiocytoses in 13.1% (n=8). Among these patients with secondary hypophysitis, pituitary deficiency preceded systemic manifestations in 23% of cases and occurred concomitantly in 23% of cases. Gonadotroph deficiency was more frequent in sarcoidosis (75%) than in other etiologies of hypophysitis (p |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1093/ejendo/lvae164 |
| Availability: |
https://amu.hal.science/hal-05017805; https://amu.hal.science/hal-05017805v1/document; https://amu.hal.science/hal-05017805v1/file/deciphering%20preprint.pdf; https://doi.org/10.1093/ejendo/lvae164 |
| Rights: |
https://about.hal.science/hal-authorisation-v1/ ; info:eu-repo/semantics/OpenAccess |
| Accession Number: |
edsbas.81F08A54 |
| Database: |
BASE |