Ju Jia-Sheng, Cui Tao, Zhao Jing, Chen Jian-Liang, Ju Hai-Bing
Department of Neurosurgery, The Eighth Affiliated Hospital of Sun Yet-sen University, Shenzhen, China.
Department of Endocrinology, 920 Hospital of Joint Logistics Support Force of the Chinese People's Liberation Army, Kunming, China.
Arch Med Sci. 2021 Dec 14;19(4):976-986. doi: 10.5114/aoms/144628. eCollection 2023.
This meta-analysis was performed to analyze the clinical presentation, magnetic resonance imaging (MRI) characteristics, and the management of lymphocytic hypophysitis (LYH).
Four different databases were searched from January 2010 to December 2020, two researchers independently conducted literature screening, data extraction, and quality evaluation. We used a random effects meta-analysis to calculate summary relative risks with 95% CI.
This meta-analysis showed that the percentage of women among LYH patients was 78%. LYH was associated with pregnancy in 15% of female patients, with headache (49%) and symptoms of central diabetes insipidus (CDI) (45%) being the most frequent presentation. In 24% of LYH patients, there was an association with another autoimmune disease. The incidence of secondary hypogonadism, secondary hypoadrenalism, secondary hypothyroidism, and growth hormone deficit was 54%, 49%, 43%, and 22%, respectively. Pituitary contrast enhancement (63%), symmetrical pituitary enlargement (60%), thickening of the pituitary stalk (58%), sella mass or suprasellar extension (58%), and loss of posterior pituitary hyperintensity (50%) were typical MRI findings. Regarding LYH treatment, the percentage of patients who had observation or hormone replacement, steroid therapy, and surgery was 43%, 36%, and 34%, respectively.
It is of great significance to fully understand the clinical characteristics of lymphocytic hypophysitis, reduce missed diagnosis and misdiagnosis, avoid unnecessary surgery and maintain normal pituitary function.
本荟萃分析旨在分析淋巴细胞性垂体炎（LYH）的临床表现、磁共振成像（MRI）特征及治疗方法。
检索了2010年1月至2020年12月期间的四个不同数据库，两名研究人员独立进行文献筛选、数据提取和质量评估。我们采用随机效应荟萃分析来计算95%置信区间的汇总相对风险。
本荟萃分析显示，LYH患者中女性占比78%。15%的女性患者的LYH与妊娠有关，最常见的表现是头痛（49%）和中枢性尿崩症（CDI）症状（45%）。24%的LYH患者与另一种自身免疫性疾病有关。继发性性腺功能减退、继发性肾上腺功能减退、继发性甲状腺功能减退和生长激素缺乏的发生率分别为54%、49%、43%和22%。垂体对比增强（63%）、垂体对称性增大（60%）、垂体柄增厚（58%）、鞍区肿块或鞍上延伸（58%）以及垂体后叶高信号消失（50%）是典型的MRI表现。关于LYH的治疗，接受观察或激素替代、类固醇治疗和手术的患者比例分别为43%、36%和34%。
充分了解淋巴细胞性垂体炎的临床特征、减少漏诊和误诊、避免不必要的手术并维持垂体正常功能具有重要意义。
