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• W2807550187 abstract "Hypophysitis is a rare condition characterised by inflammation of the pituitary gland, usually resulting in hypopituitarism and pituitary enlargement. Pituitary inflammation can occur as a primary hypophysitis (most commonly lymphocytic, granulomatous or xanthomatous disease) or as secondary hypophysitis (as a result of systemic diseases, immunotherapy or alternative sella-based pathologies). Hypophysitis can be classified using anatomical, histopathological and aetiological criteria. Non-invasive diagnosis of hypophysitis remains elusive, and the use of currently available serum anti-pituitary antibodies are limited by low sensitivity and specificity. Newer serum markers such as anti-rabphilin 3A are yet to show consistent diagnostic value and are not yet commercially available. Traditionally considered a very rare condition, the recent recognition of IgG4-related disease and hypophysitis as a consequence of use of immune modulatory therapy has resulted in increased understanding of the pathophysiology of hypophysitis. Modern imaging techniques, histological classification and immune profiling are improving the accuracy of the diagnosis of the patient with hypophysitis. The objective of this review is to bring readers up-to-date with current understanding of conditions presenting as hypophysitis, focussing on recent advances and areas for future development. We describe the presenting features, investigation and diagnostic approach of the patient with likely hypophysitis, including existing conventional techniques and those in the research/development arena. Hypophysitis usually results in acute and persistent pituitary hormone deficiency requiring long-term replacement. Management of hypophysitis includes control of the inflammatory pituitary mass using a variety of treatment strategies including surgery and medical therapy. Glucocorticoids remain the mainstay of medical treatment but other immunosuppressive agents (e.g. azathioprine, rituximab) show benefit in some cases, but there is a need for controlled studies to inform practice." @default.
• W2807550187 created "2018-06-13" @default.
• W2807550187 creator A5027982727 @default.
• W2807550187 creator A5056475928 @default.
• W2807550187 creator A5076211111 @default.
• W2807550187 date "2018-09-01" @default.
• W2807550187 modified "2023-10-11" @default.
• W2807550187 title "MECHANISMS IN ENDOCRINOLOGY: Hypophysitis: diagnosis and treatment" @default.
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• W2807550187 doi "https://doi.org/10.1530/eje-17-0009" @default.
• W2807550187 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/29880706" @default.
• W2807550187 hasPublicationYear "2018" @default.
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