ECE2023 Rapid Communications Rapid Communications 7: Pituitary and Neuroendocrinology 2 (6 abstracts)
Evaluation and follow-up data of patients diagnosed with hypophysitis: A multicentric nationwide study
Aysa Hacioglu 1 , Zuleyha Karaca 1 , Serhat Uysal 2 , Hande Mefkure Ozkaya 2 , Pinar Kadioglu 2 , Ozlem Soyluk Selcukbiricik 3 , Sema Yarman 3 , Nurdan Gul 3 , Damla Köksalan 4 , Alev Selek 4 , Berrin Cetinarslan 4 , Zeynep Canturk 4 , Fatma Tuğçe Şah ünal 5 , Demet Çorapçıoğlu 5 , Mustafa Sahin 5 , Afruz Babayeva 6 , Mujde Akturk 6 , Ayten Eraydin 7 , Semin Fenkci 7 , Hamide Piskinpasa 8 , Sema Ciftci 8 , Meriç Dökmetaş 9 , Onur Şahin 9 , H. Sebile Dokmetas 10 , Sadettin Öztürk 11 , Ersin Akarsu 11 , Elif Kılıç Kan 12 , Aysegul Atmaca 12 , Esma Pehlivan 13 , Fusun Saygili 13 , Buruc Erkan 14 , Sebnem Burhan 14 , Tülay Omma 15 , Ziynet Alphan Uc 16 , Gulsah Elbuken 17 , Fahri Bayram 1 , Goknur Yorulmaz 18 , Guven Baris Cansu 19 , Hayri Bostan 20 , Kubra Turan 21 , Selcuk Yusuf Sener 22 , Suheyla Gorar 23 , Zafer Pekkolay 24 , Zeliha Hekimsoy 25 , Hakan Dogruel 26 , Melek Eda Ertorer 27 , Ömercan Topaloğlu 28 , Ozlem Celik 29 , Ozlem Iyidir 30 & Fahrettin Kelestimur 31
1Erciyes University Medical School, Endocrinology Department, Kayseri, Turkey; 2Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Endocrinology Department, Istanbul, Turkey; 3Istanbul University Istanbul Faculty of Medicine, Endocrinology Department, Istanbul, Turkey; 4Kocaeli University Faculty of Medicine, Endocrinology Department, Kocaeli, Turkey; 5Ankara University Faculty of Medicine, Endocrinology Department, Ankara, Turkey; 6Gazi University Faculty of Medicine, Endocrinology Department, Ankara, Turkey; 7Pamukkale University School of Medicine, Endocrinology Department, Denizli, Turkey; 8Bakirkoy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, Endocrinology Department, Istanbul, Turkey; 9Istanbul Medipol University, Faculty of Medicine, Department of Internal Medicine, Istanbul, Turkey; 10Istanbul Medipol University, Faculty of Medicine, Endocrinology Department, Istanbul, Turkey; 11Gaziantep University Faculty of Medicine, Endocrinology Department, Gaziantep, Turkey; 12Ondokuz Mayis University Faculty of Medicine, Endocrinology Department, Samsun, Turkey; 13Ege University School of Medicine, Endocrinology Department, Izmir, Turkey; 14Basaksehir Cam and Sakura City Hospital, University of Health Sciences, Endocrinology Department, Istanbul, Turkey; 15Ankara Training and Research Hospital, Endocrinology Department, Ankara, Turkey; 16Usak Training and Research Hospital, Endocrinology Department, Usak, Turkey; 17Namık Kemal University Faculty of Medicine, Endocrinology Department, Tekirdag, Turkey; 18Eskişehir Osmangazi University Faculty of Medicine, Endocrinology Department, Eskisehir, Turkey; 19Kutahya Health Science University, Endocrinology Department, Kutahya, Turkey; 20Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Endocrinology Department, Ankara, Turkey; 21Yildirim Beyazit University, Faculty of Medicine, Ankara City Hospital, Endocrinology Department, Ankara, Turkey; 22Maltepe Medical Park Hospital, Endocrinology Department, Istanbul, Turkey; 23Antalya Training and Research Hospital, Endocrinology Department, Antalya, Turkey; 24Dicle University Faculty of Medicine, Endocrinology Department, Diyarbakir, Turkey; 25Celal Bayar University School of Medicine, Endocrinology Department, Manisa, Turkey; 26Akdeniz University Hospital, Endocrinology Department, Antalya, Turkey; 27Başkent University School of Medicine, Endocrinology Department, Adana, Turkey; 28Zonguldak Bulent Ecevit University, Faculty of Medicine, Endocrinology Department, Zonguldak, Turkey; 29Acibadem University School of Medicine, Endocrinology Department, Istanbul, Turkey; 30Başkent University, Faculty of Medicine, Endocrinology Department, Ankara, Turkey; 31Yeditepe University, Faculty of Medicine, Endocrinology Department, Istanbul, Turkey
Background: Hypophysitis is a rare group of disease characterized with infla mmation of the pituitary gland. Rarity of the disease obviates development of a treatment strategy. We aimed to present the nationwide data of the demographics, clinical and radiological characteristics, treatment modalities and responses of the patients diagnosed with hypophysitis in a retrospective manner.
Methods: The endocrinology clinics all over the country were invited to the study. The patients’ charts and computer-based records were retrospectively reviewed by an endocrinologist from each center. Protocol templates were used for data collection which were analyzed by the principal investigators.
Results: The data of 154 patients (109 female, 45 male) with a median (range) age of 37 (16-82) years from 30 clinics was analyzed. The most common symptoms were headache (57.1%), polyuria-polydipsia (47.4%), and fatigue (30.5%). The most common pituitary MRI findings were stalk thickening (67.6%), increased contrast enhancement (34.5%), and absence of neurohypophyseal bright spot (31.1%). The diagnosis of 110 patients was based on clinical and radiological evaluation, while 8 were performed biopsy, and 36 surgery. 115 patients (90 female, 25 male) had primary hypophysitis, 31 secondary hypophysitis (13 histiocytosis, 8 sarcoidosis, other:10), and 8 were undetermined. The median (range) follow-up was 23.5 (1-300) months. 52 (45.2%) patients presumably had lymphocytic hypophysitis, 21 of whom had histologic verification. 71 patients (62.8%) with primary hypophysitis had at least one anterior pituitary hormone deficiency, and 46 (40.7%) had diabetes insipidus. In primary hypophysitis group 54 patients were followed without interventions, and 50% (23/46) had radiologic improvement. 26 patients were started on steroid therapy with a median (range) metilprednisolone starting dose of 100 mg (40-1000), and a median treatment duration of 6 weeks (2-12). 64.7% (11/17) of the patients had radiologic improvement. The patients treated with glucocorticoids had more severe MRI findings at presentation compared to those that were followed without interventions. 36 patients with primary hypophysitis were performed surgery. The main indication was presence of compression symptoms and/or indeterminate diagnosis in 24 (66.6%) patients, while unresponsiveness to steroid therapy and assumption of a functional adenoma were other reasons. 2 patients had radiologic progression despite surgery followed by steroid therapy.
Conclusion: The study provides follow-up data of a nationwide large cohort diagnosed with hypophysitis. Clinically and radiologically mild cases might be followed without interventions. Glucocorticoids proved efficacious in some cases though the optimal dose and duration are not known. Surgery may be preferred for treatment-resistant and indeterminate cases.
Article tools
My recent searches
My recently viewed abstracts
Authors
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more