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Obstetrical & Gynecological Survey Feb 2011Lymphocytic adenohypophysitis is a rare but important cause of decreased pituitary function, which predominantly affects young women in pregnancy or the peripartum... (Review)
Review
UNLABELLED
Lymphocytic adenohypophysitis is a rare but important cause of decreased pituitary function, which predominantly affects young women in pregnancy or the peripartum period. It is an autoimmune disease of the pituitary gland which can present with varying degrees of pituitary hormonal impairment and/or with symptoms related to pituitary enlargement.
TARGET AUDIENCE
Obstetricians & gynecologists.
LEARNING OBJECTIVES
After completing this CME activity, physicians should be better able to describe the given clinical features of lymphocytic hypophysitis, conduct a differential diagnosis, and select the appropriate treatments for patients with lymphocytic hypophysitis.
Topics: Autoimmune Diseases; Female; Humans; Pituitary Diseases; Pituitary Gland, Anterior; Pregnancy; Pregnancy Complications
PubMed: 21592417
DOI: 10.1097/OGX.0b013e31821d4047 -
Best Practice & Research. Clinical... Mar 2005Lymphocytic hypophysitis (LYH) is a pituitary disease which can cause headache, changes in visual field and pituitary dysfunction. The clinical, histopathological and... (Review)
Review
Lymphocytic hypophysitis (LYH) is a pituitary disease which can cause headache, changes in visual field and pituitary dysfunction. The clinical, histopathological and morphological findings and its association with other autoimmune disorders allow LYH to be included among the autoimmune diseases. Pituitary trans-sphenoidal biopsy is thought to be the diagnostic gold standard for LYH, even if some morphological findings on hypothalamic-pituitary magnetic resonance imaging (MRI) can suggest the occurrence of this disease. Despite the fact that organ-specific antibodies are good markers of many autoimmune endocrine diseases, the pathogenetic and diagnostic roles of anti-pituitary antibodies (APAs) in LYH are still under discussion. In fact, several methods have been used to detect APAs, but the conflicting results from different methods have impaired the clinical relevance of these antibodies. Recently, APAs have been detected by an immunofluorescence method in patients with selective idiopathic hypopituitarism (particularly in those with growth-hormone deficiency) and in adults with autoimmune endocrine diseases. The results suggest that only when they are present at high titres may they be considered a good marker of pituitary involvement, and in particular of growth-hormone-producing cells.
Topics: Animals; Autoantibodies; Autoimmune Diseases; Humans; Inflammation; Lymphocytes; Pituitary Diseases; Pituitary Gland
PubMed: 15826923
DOI: 10.1016/j.beem.2004.11.007 -
Postgraduate Medical Journal May 1996The advent of sophisticated and sensitive radiologic techniques has undoubtedly improved the evaluation of patients with established endocrine disease. An inevitable... (Review)
Review
The advent of sophisticated and sensitive radiologic techniques has undoubtedly improved the evaluation of patients with established endocrine disease. An inevitable consequence of the increased sensitivity and widespread availability of modern imaging is, however, the discovery of apparently asymptomatic mass lesions in endocrine tissues. The clinician is then required to determine the appropriate degree of often uncomfortable and costly investigation in a patient with no overt disease. This article attempts to provide guidelines for the management of the 'pituitary incidentaloma', a pituitary mass lesion evident on a computed tomography or magnetic resonance imaging scan performed for a reason other than the evaluation of the pituitary gland.
Topics: Acromegaly; Adenoma; Cushing Syndrome; Diagnosis, Differential; Female; Humans; Hyperpituitarism; Hypopituitarism; Pituitary Diseases; Pituitary Neoplasms; Prolactinoma
PubMed: 8761496
DOI: 10.1136/pgmj.72.847.258 -
Obstetrics and Gynecology Clinics of... Dec 2004The hypothalamic-pituitary-adrenal axis is central to mammalian reproductive function, including conception, pregnancy maintenance, parturition, and breastfeeding.... (Review)
Review
The hypothalamic-pituitary-adrenal axis is central to mammalian reproductive function, including conception, pregnancy maintenance, parturition, and breastfeeding. Pregnancy is associated with substantial physiologic changes within this endocrine axis to meet the demands of pregnancy, which include support of the fetus (volume support, nutritional and oxygen supply, clearance of fetal waste), protection of the fetus (from starvation, drugs, toxins), preparation of the uterus for labor, and protection of the mother from potential cardiovascular injury at delivery. This article reviews the anatomy, embryology, and physiology of the pituitary. The effect of pregnancy on pituitary structure and function, in health and disease, also is discussed.
Topics: Female; Humans; Pituitary Diseases; Pituitary Gland; Pituitary Hormones, Anterior; Pituitary Neoplasms; Pregnancy; Pregnancy Complications, Neoplastic; Prolactinoma
PubMed: 15550340
DOI: 10.1016/j.ogc.2004.08.003 -
Clinical Endocrinology Oct 2016The spectrum of pituitary stalk (PS) pathology is vast, presenting a diagnostic challenge. Published large series of PS lesions demonstrate neoplastic conditions are... (Review)
Review
The spectrum of pituitary stalk (PS) pathology is vast, presenting a diagnostic challenge. Published large series of PS lesions demonstrate neoplastic conditions are most frequent, followed by inflammatory, infectious and congenital diseases. Inflammatory pathologies however, account for the majority of PS lesions in published small case series and case reports. Physicians must be familiar with the major differential diagnoses and necessary investigations. A comprehensive history and thorough clinical examination is critical. Although magnetic resonance imaging of the PS in disease is nonspecific, associated intracranial features may narrow the differential diagnosis. Initial investigations include basic pathology and computer tomography imaging of the neck, chest, abdomen and pelvis. Further investigations should be guided by the clinical context. PS biopsy should be considered when a diagnosis is regarded essential in centres where an experienced neurosurgeon is available. Treatment is dependent on the underlying disease process and may necessitate pituitary hormone replacement.
Topics: Diagnosis, Differential; Diagnostic Imaging; Humans; Pituitary Diseases; Pituitary Gland; Pituitary Neoplasms
PubMed: 26950774
DOI: 10.1111/cen.13058 -
Endocrine Practice : Official Journal... Jul 2015Pituitary lesions are common in the general population. Patients can present with a wide range of signs and symptoms that can be related to tumor mass effects or... (Review)
Review
AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY DISEASE STATE CLINICAL REVIEW: POSTOPERATIVE MANAGEMENT FOLLOWING PITUITARY SURGERY.
Pituitary lesions are common in the general population. Patients can present with a wide range of signs and symptoms that can be related to tumor mass effects or pituitary hormonal alterations. Evaluation involves assessing patients for the extent of tumor burden and pituitary hyper- or hypofunction and includes clinical exams, hormonal testing, and brain imaging. Preoperative diagnosis and treatment planning generally require a multidisciplinary team approach with expertise from endocrinologists, neurosurgeons, neuro-ophthalmologists, and neuroradiologists. This review will outline considerations for the evaluation and management of patients with pituitary masses at each stage in their treatment including the pre-, peri- and postoperative phases.
Topics: Endocrinology; Humans; Perioperative Care; Pituitary Diseases; Societies, Medical
PubMed: 26172128
DOI: 10.4158/EP14541.DSCR -
The Journal of Clinical Endocrinology... Feb 2023
Topics: Humans; Pituitary ACTH Hypersecretion; Roscovitine; Pituitary Gland; Pituitary Diseases; Neoplasms
PubMed: 36378569
DOI: 10.1210/clinem/dgac666 -
Surgical Pathology Clinics Jun 2020Sellar region lesions include a broad range of benign and malignant neoplastic as well as non-neoplastic entities, many of which are newly described or have recently... (Review)
Review
Sellar region lesions include a broad range of benign and malignant neoplastic as well as non-neoplastic entities, many of which are newly described or have recently revised nomenclature. In contrast to other intracranial sites, imaging features are relatively less specific, and the need for histopathological diagnosis is of paramount importance. This review will describe pituitary adenomas, inflammatory lesions, and tumors unique to the region (craniopharyngioma) as well as tumors which may occur in but are not exclusively localized to the sellar location (schwannoma, metastasis, etc.).
Topics: Adenoma; Central Nervous System Cysts; Craniopharyngioma; Diagnosis, Differential; Humans; Hypophysitis; Immunoglobulin G4-Related Disease; Pituitary Diseases; Pituitary Gland; Pituitary Neoplasms
PubMed: 32389269
DOI: 10.1016/j.path.2020.02.006 -
Medicine Sep 2007Hypothalamic-pituitary (HP) sarcoidosis has 2 main endocrine manifestations: diabetes insipidus and hyperprolactinemia. We conducted the current study to investigate... (Review)
Review
Hypothalamic-pituitary (HP) sarcoidosis has 2 main endocrine manifestations: diabetes insipidus and hyperprolactinemia. We conducted the current study to investigate pituitary dysfunction and perform imaging of the HP area in patients both immediately following diagnosis and after treatment. The study included 6 men and 3 women, with a mean age of 30 years at the onset of sarcoidosis. All patients had both hormonal and magnetic resonance imaging (MRI) HP disorders. All patients had anterior pituitary dysfunction, 7 of them with associated diabetes insipidus. Nine patients had gonadotropin deficiency and 3 had hyperprolactinemia. MRI revealed infundibulum involvement in 5 patients, pituitary stalk thickness abnormality in 5, and involvement of the pituitary gland in 2, associated with other parenchymal brain or spinal cord lesions in 6 patients. All patients had multiple localizations of sarcoidosis, and 5 had histologically confirmed sinonasal localizations. Mean follow-up of the HP disorder was 7.5 years. All patients received prednisone. There was no correlation between the number of hormonal dysfunctions and the area of the HP axis involved as assessed by MRI. Although corticoid treatment was associated with a reduction of radiologic lesions, only 2 patients had partial recovery of hormonal deficiency. In conclusion, hormonal deficiencies associated with HP sarcoidosis frequently include hypogonadism (all patients) and to a lesser degree diabetes insipidus (7 of 9 patients). MRI abnormalities improved or disappeared in 7 cases under corticosteroid treatment, but most endocrine defects were irreversible despite regression of the granulomatous process. Most cases presented with multivisceral localizations and an abnormally high proportion of sinonasal localizations.
Topics: Adolescent; Adult; Diabetes Insipidus; Female; Follow-Up Studies; France; Glucocorticoids; Humans; Hyperprolactinemia; Magnetic Resonance Imaging; Male; Middle Aged; Pituitary Diseases; Pituitary Gland; Pituitary Hormones, Anterior; Prednisone; Radiography; Research Design; Retrospective Studies; Sarcoidosis; Thyrotropin-Releasing Hormone; Treatment Outcome
PubMed: 17873755
DOI: 10.1097/MD.0b013e31815585aa -
Trends in Endocrinology and Metabolism:... Nov 2005External beam radiotherapy has been used extensively in the management of patients with pituitary disease. However, in view of advances in the techniques of radiotherapy... (Review)
Review
External beam radiotherapy has been used extensively in the management of patients with pituitary disease. However, in view of advances in the techniques of radiotherapy planning and administration, neurosurgery and pharmacological manipulation of the pituitary, there are a growing number of questions and controversies surrounding the current and future use of pituitary radiotherapy in the management of pituitary disease.
Topics: Humans; Neoplasms, Radiation-Induced; Pituitary Diseases; Pituitary Neoplasms; Radiation Injuries; Radiotherapy
PubMed: 16213744
DOI: 10.1016/j.tem.2005.09.008