Wehbeh Leen, Alreddawi Sama, Salvatori Roberto
a Division of Endocrinology, Diabetes and Metabolism, and Pituitary Center , The Johns Hopkins University Hospital , Baltimore , MD , USA.
b Medstar Health Internal Medicine Residency Program, Department of Medicine , Union Memorial Hospital , Baltimore , MD , USA.
Expert Rev Endocrinol Metab. 2019 May;14(3):167-178. doi: 10.1080/17446651.2019.1598260. Epub 2019 Apr 3.
Hypophysitis is a rare disorder, defined as inflammation of the pituitary gland that may result in pituitary enlargement and varying anterior and posterior pituitary hormonal deficits. It involves different histopathological subtypes and variable etiologies, with considerable overlap between classification systems. Histopathology is the gold standard diagnostic approach.
In this article, we will review the major histopathological subtypes of hypophysitis with a special focus on immunoglobulin G4 (IgG4)-related hypophysitis and immune checkpoint inhibitor-induced hypophysitis, given their recent appearance and increasing incidence. We will summarize the similarities and differences between the different subtypes as it relates to epidemiology, pathogenesis, presentation, diagnosis, and management.
Hypophysitis is a heterogeneous and wide term used to describe different, possibly distinct diseases often with poorly understood pathogenesis. It involves a wide range of subtypes with certain differences in incidence rates, pathogenesis, and management. Management usually focuses on relieving the mass effect symptoms and replacing the deficient pituitary hormones. Spontaneous recovery is possible but recurrence is not uncommon.
垂体炎是一种罕见疾病，定义为垂体的炎症，可能导致垂体增大以及不同程度的垂体前叶和后叶激素缺乏。它涉及不同的组织病理学亚型和多种病因，不同分类系统之间存在相当大的重叠。组织病理学是金标准诊断方法。
在本文中，鉴于免疫球蛋白G4（IgG4）相关性垂体炎和免疫检查点抑制剂诱导性垂体炎的新近出现及发病率上升，我们将回顾垂体炎的主要组织病理学亚型，并特别关注这两种类型。我们将总结不同亚型在流行病学、发病机制、临床表现、诊断和治疗方面的异同。
垂体炎是一个异质性的宽泛术语，用于描述不同的、可能截然不同的疾病，其发病机制往往不甚明了。它包括多种亚型，在发病率、发病机制和治疗方面存在一定差异。治疗通常侧重于缓解占位效应症状和补充缺乏的垂体激素。有可能自发恢复，但复发并不罕见。
