Evaluation and follow-up of patients diagnosed with hypophysitis: a cohort study
Authors' conclusion
The rate of spontaneous improvement might justify observation in mild cases. Glucocorticoids proved superior to observation in terms of hormonal and radiologic improvements. Surgery may not be curative and might be considered in indeterminate, treatment-resistant, or severe cases.
Study context
- Population
- Patients with primary hypophysitis recruited nationwide; 78.8% female, median age 36 years
- Participants
- 113 patients
- Exposure
- Glucocorticoid therapy vs observation vs surgery in primary hypophysitis
- Outcome
- Hormonal and radiologic improvement
Methodological detailsnationwide
- Nationwide
Main finding
As reported in the abstract
Glucocorticoid vs ObservationHazard ratio (95% CI)
Hormonal improvement; Cox regression
4.60(1.62–12.84)
Radiologic improvement; Cox regression
3.1(1.40–6.68)
Observational data: associations, not effects.
Further findings
Management at presentation
- Recurrence after surgery
- 9%
Clinical features
- Lymphocytic hypophysitis (of 45 pathologically diagnosed)
- 46.7%
- Granulomatous hypophysitis (of 45 pathologically diagnosed)
- 35.6%
- Headache, most common symptom
- 75.8%
- Central hypogonadism, most common hormone insufficiency
- 49.5%
- Headache, suprasellar extension and chiasmal compression more common with glucocorticoid than observation
Recurrence after surgery
- Main indication for surgery: inability to exclude pituitary adenoma with compression symptoms
Original publication
Evaluation and follow-up of patients diagnosed with hypophysitis: a cohort study. Eur J Endocrinol. Published 26 August 2024. doi:10.
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