Document Detail


IgG4-related hypophysitis: a new addition to the hypophysitis spectrum.
MedLine Citation:
PMID:  21593109     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: Hypophysitis is a chronic inflammation of the pituitary gland that comprises an increasingly complex clinicopathological spectrum. Within this spectrum, lymphocytic and granulomatous hypophysitis are the most common forms, but newer variants have recently been reported.
OBJECTIVE: The aims of the study were to describe a new patient with IgG4-related hypophysitis, review the published literature, and provide diagnostic criteria.
SETTING: A 75-yr-old man presented with a 1-yr history of frontal headache. Initial studies revealed panhypopituitarism and a mass in both the sella turcica and the sphenoidal sinus. The patient underwent transphenoidal surgery, initiated high-dose prednisone followed by hormone replacement therapy, and was closely monitored for 3 yr.
RESULTS: Symptoms improved after prednisone, along with shrinkage of the pituitary and sphenoidal masses, but recurred when prednisone dose was lowered. Histopathology showed a marked mononuclear infiltrate in both the pituitary and sphenoidal specimens, mainly characterized by increased numbers of plasma cells. Many of the infiltrating plasma cells (>10 per high-power field) were IgG4-positive. Review of the literature identified 11 cases of IgG4-related hypophysitis (two diagnosed based on pituitary histopathology).
CONCLUSIONS: We describe the first Caucasian patient with biopsy-proven IgG4-related hypophysitis and provide classification criteria for this disease.
Authors:
Paola Leporati; Melissa A Landek-Salgado; Isabella Lupi; Luca Chiovato; Patrizio Caturegli
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, N.I.H., Extramural     Date:  2011-05-18
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  96     ISSN:  1945-7197     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-07-07     Completed Date:  2011-09-12     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1971-80     Citation Subset:  AIM; IM    
Affiliation:
Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Headache / etiology*,  immunology,  surgery
Humans
Hypophysectomy
Immunoglobulin G / immunology*
Male
Pituitary Diseases / complications,  diagnosis*,  immunology,  surgery
Pituitary Gland / immunology*,  surgery
Treatment Outcome
Grant Support
ID/Acronym/Agency:
DK080351/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Immunoglobulin G
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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