Hypophysitis : new insights into diagnosis and treatment

2019
journal article
review article
dc.abstract.enHypophysitis is a broad term used to describe conditions leading to inflammation of the pituitary gland and the pituitary stalk. It may develop as a primary condition or secondary to other diseases. Hypophysitis is classified based on aetiological, anatomical, and histological criteria. Clinical symptoms result from enlargement of the pituitary gland, hormonal deficiencies, diabetes insipidus, and hyperprolactinemia. Histopathological verification of tissue samples from a pituitary biopsy remains the gold standard in diagnosing hypophysitis. However, due to the invasiveness and risk of the procedure it is rarely performed. The diagnosis is based mainly on clinical presentation, laboratory tests, and imaging. The rarity of the disease and the deficit in reliable data result in a lack of clear guidelines in the treatment of hypophysitis. The basic therapy relies on hormonal replacement. High doses of steroids are the first-line treatment of symptoms caused by mass effect in sella and compression of surrounding structures. In steroid-resistant patients or in cases of inacceptable sides effects, treatment with other immunosuppressant drugs was administered with success. The course of the disease varies: some patients present remission, in other cases hypophysitis leads to fibrosis and atrophy of the pituitary gland, which is reflected in persistent hormonal deficiencies and images of an empty sella. The objective of this article is to present the most important information: the epidemiology, clinical image, diagnostic procedures, and treatment of primary hypophysitis, in order to allow better understanding of this disease and implementation of proper management. Posttraumatic and immunotherapyrelated hypophysitis are also briefly characterised.pl
dc.affiliationWydział Lekarski : Klinika Endokrynologiipl
dc.cm.date2020-12-02
dc.cm.id95614
dc.contributor.authorKluczyński, Łukasz - 148616 pl
dc.contributor.authorGilis-Januszewska, Aleksandra - 129503 pl
dc.contributor.authorRogoziński, Damianpl
dc.contributor.authorPantofliński, Jacekpl
dc.contributor.authorHubalewska-Dydejczyk, Alicja - 129732 pl
dc.date.accession2019-09-06pl
dc.date.accessioned2020-12-02T10:07:34Zpl
dc.date.available2020-12-02T10:07:34Zpl
dc.date.issued2019pl
dc.date.openaccess0
dc.description.accesstimew momencie opublikowania
dc.description.number3pl
dc.description.physical260-269pl
dc.description.points40pl
dc.description.versionostateczna wersja wydawcy
dc.description.volume70pl
dc.identifier.doi10.5603/EP.a2019.0015pl
dc.identifier.eissn2299-8306pl
dc.identifier.issn0423-104Xpl
dc.identifier.projectROD UJ / OPpl
dc.identifier.urihttps://ruj.uj.edu.pl/xmlui/handle/item/255987
dc.identifier.weblinkhttps://journals.viamedica.pl/endokrynologia_polska/article/view/63051pl
dc.languageengpl
dc.language.containerengpl
dc.rightsUdzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Bez utworów zależnych 4.0 Międzynarodowa*
dc.rights.licenceCC-BY-NC-ND
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pl/legalcode *
dc.share.typeotwarte czasopismo
dc.subject.enhypophysitispl
dc.subject.enpituitary insufficiencypl
dc.subject.enhypopituitarismpl
dc.subject.endiabetes insipiduspl
dc.subtypeReviewArticlepl
dc.titleHypophysitis : new insights into diagnosis and treatmentpl
dc.title.journalEndokrynologia Polskapl
dc.typeJournalArticlepl
dspace.entity.typePublication
dc.abstract.enpl
Hypophysitis is a broad term used to describe conditions leading to inflammation of the pituitary gland and the pituitary stalk. It may develop as a primary condition or secondary to other diseases. Hypophysitis is classified based on aetiological, anatomical, and histological criteria. Clinical symptoms result from enlargement of the pituitary gland, hormonal deficiencies, diabetes insipidus, and hyperprolactinemia. Histopathological verification of tissue samples from a pituitary biopsy remains the gold standard in diagnosing hypophysitis. However, due to the invasiveness and risk of the procedure it is rarely performed. The diagnosis is based mainly on clinical presentation, laboratory tests, and imaging. The rarity of the disease and the deficit in reliable data result in a lack of clear guidelines in the treatment of hypophysitis. The basic therapy relies on hormonal replacement. High doses of steroids are the first-line treatment of symptoms caused by mass effect in sella and compression of surrounding structures. In steroid-resistant patients or in cases of inacceptable sides effects, treatment with other immunosuppressant drugs was administered with success. The course of the disease varies: some patients present remission, in other cases hypophysitis leads to fibrosis and atrophy of the pituitary gland, which is reflected in persistent hormonal deficiencies and images of an empty sella. The objective of this article is to present the most important information: the epidemiology, clinical image, diagnostic procedures, and treatment of primary hypophysitis, in order to allow better understanding of this disease and implementation of proper management. Posttraumatic and immunotherapyrelated hypophysitis are also briefly characterised.
dc.affiliationpl
Wydział Lekarski : Klinika Endokrynologii
dc.cm.date
2020-12-02
dc.cm.id
95614
dc.contributor.authorpl
Kluczyński, Łukasz - 148616
dc.contributor.authorpl
Gilis-Januszewska, Aleksandra - 129503
dc.contributor.authorpl
Rogoziński, Damian
dc.contributor.authorpl
Pantofliński, Jacek
dc.contributor.authorpl
Hubalewska-Dydejczyk, Alicja - 129732
dc.date.accessionpl
2019-09-06
dc.date.accessionedpl
2020-12-02T10:07:34Z
dc.date.availablepl
2020-12-02T10:07:34Z
dc.date.issuedpl
2019
dc.date.openaccess
0
dc.description.accesstime
w momencie opublikowania
dc.description.numberpl
3
dc.description.physicalpl
260-269
dc.description.pointspl
40
dc.description.version
ostateczna wersja wydawcy
dc.description.volumepl
70
dc.identifier.doipl
10.5603/EP.a2019.0015
dc.identifier.eissnpl
2299-8306
dc.identifier.issnpl
0423-104X
dc.identifier.projectpl
ROD UJ / OP
dc.identifier.uri
https://ruj.uj.edu.pl/xmlui/handle/item/255987
dc.identifier.weblinkpl
https://journals.viamedica.pl/endokrynologia_polska/article/view/63051
dc.languagepl
eng
dc.language.containerpl
eng
dc.rights*
Udzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Bez utworów zależnych 4.0 Międzynarodowa
dc.rights.licence
CC-BY-NC-ND
dc.rights.uri*
http://creativecommons.org/licenses/by-nc-nd/4.0/pl/legalcode 
dc.share.type
otwarte czasopismo
dc.subject.enpl
hypophysitis
dc.subject.enpl
pituitary insufficiency
dc.subject.enpl
hypopituitarism
dc.subject.enpl
diabetes insipidus
dc.subtypepl
ReviewArticle
dc.titlepl
Hypophysitis : new insights into diagnosis and treatment
dc.title.journalpl
Endokrynologia Polska
dc.typepl
JournalArticle
dspace.entity.type
Publication
Affiliations

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