Pituitary & hypothalamus

Hypophysitis in COVID-19: a systematic review

PituitaryPublished Systematic review of case reports

Authors' conclusion

Although rare, hypophysitis related to COVID-19 is documented in the literature exhibiting distinct characteristics such as a homogeneous gender prevalence, an average age of onset around 35 years, and primary symptoms of headache, polyuria, and polydipsia which are indicative of angiotensin-vasopressin deficiency. This is in contrast with primary autoimmune hypophysitis characterized by a female prevalence and typical symptoms with headache and visual impairment. Longer-term follow-up of these patients is needed to better understand the potential lasting impact on pituitary function and radiological improvement. Future research should also explore the presence of anti-pituitary antibodies and the other possible pathophysiological mechanisms potentially involved in these cases.

Study context

Population
Patients with hypophysitis after COVID-19
Participants
7 reported cases
Outcome
Characteristics of reported post-COVID-19 hypophysitis cases
Methodological detailsMEDLINE (PubMed) search, July 2024, English-language literature
  • MEDLINE (PubMed) search, July 2024
  • English-language literature

Pooled result

As reported in the abstract

Reported cases of post-COVID-19 hypophysitis
7
Females
4 (57%)
Males
3 (43%)
Median age
37 years
Interval from COVID-19 symptoms to hypophysitis onset
2 to 3 weeks
Frontal headache as initial symptom
4 (57%)
Polyuria and polydipsia as initial symptom
3 (43%)
Anterior or posterior hypopituitarism
6 (85%)
Panhypophysitis on imaging
2 (28.5%)
Gland enlargement with homogeneous contrast enhancement on magnetic resonance imaging (MRI)
3 (43%)
Loss of posterior pituitary bright spot
1
Pituitary apoplexy/enlargement of gland and infundibulum
1
Glucocorticoid treatment
4 (57%)
Long-term follow-up documented (16-year-old female, 2 years; complete clinical and radiological resolution)
1

Original publication

Hypophysitis in COVID-19: a systematic review. Pituitary. Published 15 October 2024. doi:10.1007/s11102-024-01462-4

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