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西班牙内分泌与营养学会神经内分泌学知识领域垂体炎共识文件执行摘要

Executive summary of the consensus document on hypophysitis of the Neuroendocrinology Area of Knowledge of the Spanish Society of Endocrinology and Nutrition.

作者信息

Iglesias Pedro, Biagetti Betina, Guerrero-Pérez Fernando, Vicente Almudena, Cordido Fernando, Díez Juan J

机构信息

Servicio de Endocrinología y Nutrición, Hospital Universitario Puerta de Hierro Majadahonda, Instituto de Investigación Sanitaria Puerta de Hierro - Segovia de Arana (IDIPHISA), Majadahonda, Madrid, Spain; Departamento de Medicina, Universidad Autónoma de Madrid, Madrid, Spain.

Servicio de Endocrinología y Nutrición, Hospital Universitari Vall d'Hebron, Barcelona, Spain.

出版信息

Endocrinol Diabetes Nutr (Engl Ed). 2023 Mar;70 Suppl 1:116-125. doi: 10.1016/j.endien.2023.01.001. Epub 2023 Mar 7.

Abstract

The term hypophysitis is used to designate a heterogeneous group of pituitary conditions characterized by the presence of inflammatory infiltration of the adenohypophysis, neurohypophysis, or both. Although hypophysitis are rare disorders, the most common in clinical practice is lymphocytic hypophysitis, a primary hypophysitis characterized by lymphocytic infiltration, which predominantly affects women. Other forms of primary hypophysitis are associated with different autoimmune diseases. Hypophysitis can also be secondary to other disorders such as sellar and parasellar diseases, systemic diseases, paraneoplastic syndromes, infections, and drugs, including immune checkpoint inhibitors. The diagnostic evaluation should always include pituitary function tests and other analytical tests based on the suspected diagnosis. Pituitary magnetic resonance imaging is the investigation of choice for the morphological assessment of hypophysitis. Glucocorticoids are the mainstay of treatment for most symptomatic hypophysitis.

摘要

垂体炎一词用于指一组异质性的垂体疾病,其特征是腺垂体、神经垂体或两者存在炎症浸润。尽管垂体炎是罕见疾病,但临床实践中最常见的是淋巴细胞性垂体炎,这是一种以淋巴细胞浸润为特征的原发性垂体炎,主要影响女性。其他形式的原发性垂体炎与不同的自身免疫性疾病有关。垂体炎也可能继发于其他疾病,如鞍区和鞍旁疾病、全身性疾病、副肿瘤综合征、感染和药物,包括免疫检查点抑制剂。诊断评估应始终包括垂体功能测试和基于疑似诊断的其他分析测试。垂体磁共振成像(MRI)是垂体炎形态学评估的首选检查方法。糖皮质激素是大多数有症状垂体炎治疗的主要药物。

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