Spontaneous course of hypophysitis – data from a survey of the German Pituitary Working Group
| Autor: | Michael Droste, Jürgen Honegger, Stephan Petersenn, S Kacheva, C Streetz-van der Werf, Stephanie C. Werner |
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| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
Pregnancy Natural course Hypophysitis business.industry Endocrinology Diabetes and Metabolism Medizin General Medicine medicine.disease Surgery Lesion Endocrinology medicine.anatomical_structure Anterior pituitary Diabetes insipidus Internal Medicine medicine Adrenal insufficiency Endocrine system medicine.symptom business |
| Zdroj: | Experimental and Clinical Endocrinology & Diabetes. 122 |
| ISSN: | 1439-3646 0947-7349 |
| DOI: | 10.1055/s-0034-1372008 |
| Popis: | Introduction: Due to the rarity of primary hypophysitis, little is known about its natural course and the significance of current treatment options. The Pituitary Working Group of the German Society of Endocrinology has initiated a survey using a standardized questionnaire to evaluate the management and outcome of hypophysitis in Germany. Here, we present our first data on the spontaneous course of hypophysitis. Methods: So far, 23 patients with primary hypophysitis have been entered into the hypophysitis data base. Twelve of these cases were initially only kept under observation without treatment except for replacement therapy of pituitary dysfunction. Results: Eleven women and one man were followed without further treatment. Their mean age was 36 years (range 16 – 72 years). One case was associated with pregnancy. Initial endocrine assessment revealed diabetes insipidus in 67%, hypogonadism in 67%, GH deficiency in 50%, hypothyroidism in 25% and adrenal insufficiency in 50% of the patients. The mean observation period was 58 months (range 5 – 126 months). During the observation period, the pituitary lesion regressed in 7 patients. Reduction of pituitary lesion size was found on MRI for the first time after a mean period of 11 months (range 1 – 38 months) after initial diagnosis. Lesion size on MRI remained stable in 4 patients throughout the follow-up period. Progression was only found in one patient and was detected on MRI 4 months after initial diagnosis. During the observation period, anterior pituitary deficiency recovered in 5 patients. Diabetes insipidus improved in 2 patients. Deterioration of pituitary function was only observed in the case with the progressing lesion. Conclusion: Our preliminary data indicate a favourable natural course in a relatively high number of cases with primary hypophysitis. In newly diagnosed hypophysitis, observation only is justified unless the patient presents with severe or deteriorating symptoms. |
| Databáze: | OpenAIRE |
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