MECHANISMS IN ENDOCRINOLOGY: Hypophysitis: diagnosis and treatment.

摘要: Hypophysitis is a rare condition characterised by inflammation of the pituitary gland, usually resulting in hypopituitarism and enlargement. Pituitary can occur as primary hypophysitis (most commonly lymphocytic, granulomatous or xanthomatous disease) secondary (as result systemic diseases, immunotherapy alternative sella-based pathologies). be classified using anatomical, histopathological aetiological criteria. Non-invasive diagnosis remains elusive, use currently available serum anti-pituitary antibodies are limited low sensitivity specificity. Newer markers such anti-rabphilin 3A yet to show consistent diagnostic value not commercially available. Traditionally considered very condition, recent recognition IgG4-related disease consequence immune modulatory therapy has resulted increased understanding pathophysiology hypophysitis. Modern imaging techniques, histological classification profiling improving accuracy patient with The objective this review bring readers up-to-date current conditions presenting hypophysitis, focussing on advances areas for future development. We describe features, investigation approach likely including existing conventional techniques those research/development arena. results acute persistent hormone deficiency requiring long-term replacement. Management includes control inflammatory mass variety treatment strategies surgery medical therapy. Glucocorticoids remain mainstay but other immunosuppressive agents (e.g. azathioprine, rituximab) benefit some cases, there need controlled studies inform practice.