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Clinical Characteristics, Management, and Outcome of 22 Cases of Primary Hypophysitis
BACKGROUND: Primary hypophysitis causes varying degrees of endocrine dysfunction and mass effect. The natural course and best treatment have not been well established. METHODS: Medical records of 22 patients who had been diagnosed with primary hypophysitis between January 2001 and March 2013 were re...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Korean Endocrine Society
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4285029/ https://www.ncbi.nlm.nih.gov/pubmed/25325267 http://dx.doi.org/10.3803/EnM.2014.29.4.470 |
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author | Park, Sun Mi Bae, Ji Cheol Joung, Ji Young Cho, Yoon Young Kim, Tae Hun Jin, Sang-Man Suh, Sunghwan Hur, Kyu Yeon Kim, Kwang-Won |
author_facet | Park, Sun Mi Bae, Ji Cheol Joung, Ji Young Cho, Yoon Young Kim, Tae Hun Jin, Sang-Man Suh, Sunghwan Hur, Kyu Yeon Kim, Kwang-Won |
author_sort | Park, Sun Mi |
collection | PubMed |
description | BACKGROUND: Primary hypophysitis causes varying degrees of endocrine dysfunction and mass effect. The natural course and best treatment have not been well established. METHODS: Medical records of 22 patients who had been diagnosed with primary hypophysitis between January 2001 and March 2013 were retrospectively reviewed. Based on the anatomical location, we classified the cases as adenohypophysitis (AH), infundibuloneurohypophysitis (INH), and panhypophysitis (PH). Clinical presentation, endocrine function, pathologic findings, magnetic resonance imaging findings, and treatment courses were reviewed. RESULTS: Among 22 patients with primary hypophysitis, 81.8% (18/22) had involvement of the posterior pituitary lobe. Two patients of the AH (2/3, 66.6%) and three patients of the PH (3/10, 30%) groups initially underwent surgical mass reduction. Five patients, including three of the PH (3/10, 33.3%) group and one from each of the AH (1/3, 33.3%) and INH (1/9, 11.1%) groups, initially received high-dose glucocorticoid treatment. Nearly all of the patients treated with surgery or high-dose steroid treatment (9/11, 82%) required continuous hormone replacement during the follow-up period. Twelve patients received no treatment for mass reduction due to the absence of acute symptoms and signs related to a compressive mass effect. Most of them (11/12, 92%) did not show disease progression, and three patients recovered partially from hormone deficiency. CONCLUSION: Deficits of the posterior pituitary were the most common features in our cases of primary hypophysitis. Pituitary endocrine defects responded less favorably to glucocorticoid treatment and surgery. In the absence of symptoms related to mass effect and with the mild defect of endocrine function, it may not require treatment to reduce mass except hormone replacement. |
format | Online Article Text |
id | pubmed-4285029 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Korean Endocrine Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-42850292015-01-06 Clinical Characteristics, Management, and Outcome of 22 Cases of Primary Hypophysitis Park, Sun Mi Bae, Ji Cheol Joung, Ji Young Cho, Yoon Young Kim, Tae Hun Jin, Sang-Man Suh, Sunghwan Hur, Kyu Yeon Kim, Kwang-Won Endocrinol Metab (Seoul) Original Article BACKGROUND: Primary hypophysitis causes varying degrees of endocrine dysfunction and mass effect. The natural course and best treatment have not been well established. METHODS: Medical records of 22 patients who had been diagnosed with primary hypophysitis between January 2001 and March 2013 were retrospectively reviewed. Based on the anatomical location, we classified the cases as adenohypophysitis (AH), infundibuloneurohypophysitis (INH), and panhypophysitis (PH). Clinical presentation, endocrine function, pathologic findings, magnetic resonance imaging findings, and treatment courses were reviewed. RESULTS: Among 22 patients with primary hypophysitis, 81.8% (18/22) had involvement of the posterior pituitary lobe. Two patients of the AH (2/3, 66.6%) and three patients of the PH (3/10, 30%) groups initially underwent surgical mass reduction. Five patients, including three of the PH (3/10, 33.3%) group and one from each of the AH (1/3, 33.3%) and INH (1/9, 11.1%) groups, initially received high-dose glucocorticoid treatment. Nearly all of the patients treated with surgery or high-dose steroid treatment (9/11, 82%) required continuous hormone replacement during the follow-up period. Twelve patients received no treatment for mass reduction due to the absence of acute symptoms and signs related to a compressive mass effect. Most of them (11/12, 92%) did not show disease progression, and three patients recovered partially from hormone deficiency. CONCLUSION: Deficits of the posterior pituitary were the most common features in our cases of primary hypophysitis. Pituitary endocrine defects responded less favorably to glucocorticoid treatment and surgery. In the absence of symptoms related to mass effect and with the mild defect of endocrine function, it may not require treatment to reduce mass except hormone replacement. Korean Endocrine Society 2014-12 2014-12-29 /pmc/articles/PMC4285029/ /pubmed/25325267 http://dx.doi.org/10.3803/EnM.2014.29.4.470 Text en Copyright © 2014 Korean Endocrine Society http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Park, Sun Mi Bae, Ji Cheol Joung, Ji Young Cho, Yoon Young Kim, Tae Hun Jin, Sang-Man Suh, Sunghwan Hur, Kyu Yeon Kim, Kwang-Won Clinical Characteristics, Management, and Outcome of 22 Cases of Primary Hypophysitis |
title | Clinical Characteristics, Management, and Outcome of 22 Cases of Primary Hypophysitis |
title_full | Clinical Characteristics, Management, and Outcome of 22 Cases of Primary Hypophysitis |
title_fullStr | Clinical Characteristics, Management, and Outcome of 22 Cases of Primary Hypophysitis |
title_full_unstemmed | Clinical Characteristics, Management, and Outcome of 22 Cases of Primary Hypophysitis |
title_short | Clinical Characteristics, Management, and Outcome of 22 Cases of Primary Hypophysitis |
title_sort | clinical characteristics, management, and outcome of 22 cases of primary hypophysitis |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4285029/ https://www.ncbi.nlm.nih.gov/pubmed/25325267 http://dx.doi.org/10.3803/EnM.2014.29.4.470 |
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