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Hypophysitis  
Hypophysis Hypophysitis Autoimmune Hypophysitis Diagnosis & Treatment Research


Definition
Historical Notes
Epidemiology
Histopathology
Symptoms
Typical Clinical Scenarios


Symptoms
The clinical presentation of Autoimmune Hypophysitis includes 4 categories of symptoms.
  1. The most common are symptoms derived from mass effect, such as headaches (47% of patients) and visual disturbances (33%).

  2. Then there are symptoms derived from the hypofunction of one or more of the adenohypophyseal hormones: the most frequent endocrine cells affected are the corticotropes (33%) and the thyreotropes (13%), followed by lactotropes (31%) and gondadotropes (26%).

  3. The third category includes the symptoms indicating an involvement of the neurohypophysis (polyuria and polydipsia), which were present in 27% of the patients.

  4. Last are the symptoms due to hyperprolactinemia (mainly amenorrhea/oligomenorrhea and galactorrhea), which were present in 23% of the patients.

    These symptoms of AH are indistinguishable from those of any expanding mass located the sella turcica. It is true that some characteristics are unique to AH, such as the observation that the degree of hypopituitarism (partial or complete) is frequently disproportionate to the size of the accompanying pituitary mass, and that the loss of hormonal function in AH (ACTH first with or without TSH, gonadotropins frequently spared and GH almost always spared) is different that the loss observed in pituitary adenomas (GH function is lost first, then gonadotropins, and then ACTH and TSH). These characteristics, however, do not permit differentiation between autoimmune hypophysitis and other sellar lesions.

 



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