Autoimmune lymphocytic hypophysitis in association with autoimmune eye disease and sequential treatment with infliximab and rituximab.

Abstract:

INTRODUCTION:Autoimmune lymphocytic hypophysitis associates predominantly with other autoimmune endocrinopathies and is most commonly treated with glucocorticoids and/or decompressive pituitary surgery. Here we report a new association and treatment modality for lymphocytic hypophysitis. METHODS:A 52-year-old woman presented with scleritis, uveitis, facial palsy, and central diabetes insipidus, accompanied by thickened pituitary stalk and enlarged pituitary on cranial MRI. Neurosarcoidosis was suspected and treatment with glucocorticoids and methotrexate initiated. Since symptoms persisted, infliximab (a monoclonal antibody that antagonizes tumor necrosis factor alpha) was added to her regimen. The patient initially improved but after 6 months developed recurrent pituitary enlargement, bilateral optic neuritis, and panhypopituitarism. To ascertain the nature of the pituitary lesion, she underwent transsphenoidal biopsy, which revealed lymphocytic hypophysitis with numerous CD20 positive B lymphocytes. The pathological finding suggested to us that administration of rituximab (a monoclonal antibody that lyzes B cells expressing CD20) could be useful. Following two courses of rituximab, the pituitary mass resolved and the corticotroph axis partially recovered. The patient has remained in remission during 3 years of follow up. CONCLUSION:This is the first report of hypophysitis occurring with the triad of scleritis, uveitis, and optic neuritis, as well as the first immunotherapy based on the sequential use of infliximab and rituximab.

journal_name

Pituitary

journal_title

Pituitary

authors

Xu C,Ricciuti A,Caturegli P,Keene CD,Kargi AY

doi

10.1007/s11102-014-0592-7

subject

Has Abstract

pub_date

2015-08-01 00:00:00

pages

441-7

issue

4

eissn

1386-341X

issn

1573-7403

journal_volume

18

pub_type

杂志文章
  • Management of recurrent pituitary cysts with pituitary-nasal drain.

    abstract::Pituitary cysts are usually craniopharyngiomas or remnants of Rathke's cleft. Histologically craniopharyngiomas are lined by stratified squamous epithelium whereas Rathke's cleft cysts are lined by cuboidal or columnar epithelium. The management of pituitary cysts remains difficult because of the risks associated with...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1023/a:1025373715860

    authors: Dashora U,Mathias D,James A,Zammit-Maempel I,Perros P

    更新日期:2002-01-01 00:00:00

  • Clinical picture and the treatment of TBI-induced hypopituitarism.

    abstract::Traumatic brain injury (TBI) is an important public health problem with an increasing incidence in the last years. Relatively few cases are fatal; most individuals will survive and, in the long-term, the sequalae of TBI will include neuroendocrine dysfunctions with a much higher frequency than previously suspected. Pa...

    journal_title:Pituitary

    pub_type: 杂志文章,评审

    doi:10.1007/s11102-019-00956-w

    authors: Caputo M,Mele C,Prodam F,Marzullo P,Aimaretti G

    更新日期:2019-06-01 00:00:00

  • Thyroid-stimulating hormone (thyrotropin)-secretion pituitary adenoma in an 8-year-old boy: case report.

    abstract::In this report, an extremely rare case of pediatric thyrotropin-secreting pituitary macroadenoma (TSHoma) is described. An 8-year-old boy, complaining of unsteady gait, was suspected of endocrinopathy because of emaciation and muscle weakness of the legs. Endocrinological work-up established a diagnosis of hyperthyroi...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-010-0275-y

    authors: Nakayama Y,Jinguji S,Kumakura S,Nagasaki K,Natsumeda M,Yoneoka Y,Saito T,Fujii Y

    更新日期:2012-03-01 00:00:00

  • Medical management of pituitary adenomas: structural and ultrastructural changes.

    abstract::The morphology of the various pituitary cell types is highly dynamic and allows recognition of many cellular functions. Most pituitary cells show morphologic changes that reflect stimulation or inhibition by hormones. Drugs have also been shown to alter the morphology of several pituitary tumor types, allowing a measu...

    journal_title:Pituitary

    pub_type: 杂志文章,评审

    doi:10.1023/a:1022320732718

    authors: Asa SL,Ezzat S

    更新日期:2002-01-01 00:00:00

  • Molecular pathogenesis of human prolactinomas identified by gene expression profiling, RT-qPCR, and proteomic analyses.

    abstract::The molecular pathogenesis of prolactinomas has resisted elucidation; with the exception of a RAS mutation in a single aggressive prolactinoma, no mutational changes have been identified. In prolactinomas, a further obstacle has been the paucity of surgical specimens suitable for molecular analysis since prolactionoma...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-007-0082-2

    authors: Evans CO,Moreno CS,Zhan X,McCabe MT,Vertino PM,Desiderio DM,Oyesiku NM

    更新日期:2008-01-01 00:00:00

  • Be careful... She has a pituitary gland in her nose.

    abstract::In this case report we describe a 38 year-old-female with galactorrhea several months after the birth of an anencephalic child. She had hyperpolactemia and imaging of the pituitary gland revealed a midline defect and a nasopharyngeal mass compatible with a meningo-(hypophyso-) encephalocele and possibly an ectopic ter...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-011-0320-5

    authors: Rabelink NM,Lips P,Castelijns JA

    更新日期:2012-12-01 00:00:00

  • Adamantinomatous craniopharyngiomas express tumor stem cell markers in cells with activated Wnt signaling: further evidence for the existence of a tumor stem cell niche?

    abstract:INTRODUCTION:Early disease onset, clinical manifestation, histomorphology, and increased tendency to relapse distinguish the adamantinomatous craniopharyngioma (adaCP) from the more favorable papillary variant (papCP). A molecular hallmark of adaCP is the activated Wnt signaling pathway indicated by nuclear β-catenin a...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-013-0543-8

    authors: Hölsken A,Stache C,Schlaffer SM,Flitsch J,Fahlbusch R,Buchfelder M,Buslei R

    更新日期:2014-12-01 00:00:00

  • Gene expression profiling in human null cell pituitary adenoma tissue.

    abstract::It is estimated that up to one in five individuals develops pituitary gland tumors, despite the common occurrence of these tumors, the pathogenetic mechanisms underlying their development mainly remain unknown. We studied the gene expression in null cell adenomas compared with normal pituitary by expressed sequence ta...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-007-0008-z

    authors: Hu J,Song H,Wang X,Shen Y,Chen F,Liu Y,Li S,Wang Y,Shou X,Zhang Y,Hu R

    更新日期:2007-01-01 00:00:00

  • Adipsic diabetes insipidus following pituitary surgery for a macroprolactinoma.

    abstract::Adipsic diabetes insipidus (ADI) is a rare condition in which thirst, an essential clinical feature for the prevention of hypernatraemic dehydration, is absent. We report the first case of adipsic diabetes insipidus to occur following surgery for a pituitary macroprolactinoma, with loss of both osmoregulated and baror...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-006-8280-x

    authors: Sherlock M,Agha A,Crowley R,Smith D,Thompson CJ

    更新日期:2006-01-01 00:00:00

  • Combined treatment of invasive giant prolactinomas.

    abstract::The management of invasive giant prolactinomas (IGP) has been an area of some controversy. The relative roles of transsphenoidal surgery, craniotomy, radiation therapy and dopamine agonist based medical therapy are gradually becoming clarified. We report the results of management of 30 patients with IGP. Surgery was t...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-005-5087-0

    authors: Yu C,Wu Z,Gong J

    更新日期:2005-01-01 00:00:00

  • A case of lymphocytic infundibuloneurohypophysitis: histophathological studies.

    abstract::A 57-year-old woman presented with 2-year history of polyuria and polydipsia. Hormonal studies revealed almost normal anterior pituitary function and central diabetes insipidus. Magnetic resonance imaging showed thickening of the pituitary stalk and enlargement of the neurohypophysis without high intensity of the post...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1023/a:1009914711287

    authors: Waki K,Yamada S,Ozawa Y,Seki K,Endo Y

    更新日期:1999-05-01 00:00:00

  • Gamma knife stereotactic radiosurgery for drug resistant or intolerant invasive prolactinomas.

    abstract::We evaluated the efficacy of Gamma knife stereotactic radiosurgery (GKSR) as an adjunctive management modality for patients with drug resistant or intolerant cavernous sinus invasive prolactinomas. Twenty-two patients with cavernous sinus invasive prolactinoma underwent GKSR between 1994 and 2009. Thirteen patients we...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-012-0376-x

    authors: Liu X,Kano H,Kondziolka D,Park KJ,Iyer A,Shin S,Niranjan A,Flickinger JC,Lunsford LD

    更新日期:2013-03-01 00:00:00

  • Moderate dose cranial radiotherapy causes central adrenal insufficiency in long-term survivors of childhood leukaemia.

    abstract::Acute lymphoblastic leukaemia (ALL) is the most common childhood malignancy. The survival rate in the Scandinavian countries is now around 85 %. ALL patients treated with cranial radiotherapy (CRT) are at risk for growth hormone deficiency (GHD), but little is known about other pituitary insufficiencies, e.g. ACTH. Ad...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-012-0459-8

    authors: Follin C,Wiebe T,Moëll C,Erfurth EM

    更新日期:2014-02-01 00:00:00

  • Mechanism of action of octreotide in acromegalic tumours in vivo using dynamic contrast-enhanced magnetic resonance imaging.

    abstract:CONTEXT:Octreotide causes significant tumour shrinkage in patients with acromegaly but the exact mechanism of action is unclear in vivo. OBJECTIVE:To determine the mechanism of action of octreotide in vivo using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). DESIGN:Five patients with acromegaly were ...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-007-0044-8

    authors: Sathyapalan T,Lowry M,Turnbull LW,Rowland-Hill C,Atkin SL

    更新日期:2007-01-01 00:00:00

  • Pituitary tuberculosis mimicking idiopathic granulomatous hypophysitis.

    abstract::An unusual case of tubercular granulomatous hypophysitis is reported. A sellar mass diagnosed as pituitary adenoma in MRI, showed non-caseating granulomas, glandular destruction and fibrosis in histology. Stain for acid-fast bacilli (AFB) were negative and the case was misdiagnosed as Idiopathic Granulomatous hypophys...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-007-0068-0

    authors: Husain N,Husain M,Rao P

    更新日期:2008-01-01 00:00:00

  • Double pituitary lesions in three patients with Cushing's disease.

    abstract::Double pituitary adenomas are rare in surgical specimens and the most common clinical feature in reported patients has been acromegaly. We report 3 cases of double pituitary lesions in patients who presented with Cushing's disease. In a 22-year-old man (case 1) with delayed puberty and low testosterone levels, mild hy...

    journal_title:Pituitary

    pub_type: 杂志文章,评审

    doi:10.1023/a:1011499609096

    authors: Meij BP,Lopes MB,Vance ML,Thorner MO,Laws ER Jr

    更新日期:2000-11-01 00:00:00

  • Machine learning applications in imaging analysis for patients with pituitary tumors: a review of the current literature and future directions.

    abstract:PURPOSE:To provide an overview of fundamental concepts in machine learning (ML), review the literature on ML applications in imaging analysis of pituitary tumors for the last 10 years, and highlight the future directions on potential applications of ML for pituitary tumor patients. METHOD:We presented an overview of t...

    journal_title:Pituitary

    pub_type: 杂志文章,评审

    doi:10.1007/s11102-019-01026-x

    authors: Saha A,Tso S,Rabski J,Sadeghian A,Cusimano MD

    更新日期:2020-06-01 00:00:00

  • Radiotherapy in paediatric Cushing's disease: efficacy and long term follow up of pituitary function.

    abstract::Pituitary radiotherapy (RT) is an effective second-line treatment for paediatric Cushing's disease (CD). We report long-term efficacy and anterior pituitary function in a cohort of paediatric CD patients treated with RT. Between 1988 and 2008, from our cohort of 48 paediatric CD patients, eight paediatric CD patients ...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-010-0231-x

    authors: Acharya SV,Gopal RA,Goerge J,Menon PS,Bandgar TR,Shah NS

    更新日期:2010-12-01 00:00:00

  • Importance of cannulated prolactin test in the definition of hyperprolactinaemia.

    abstract:PURPOSE:Recent guidelines suggest that a single prolactin measurement is adequate to confirm hyperprolactinaemia. This may lead to unnecessary investigation of artefactual hyperprolactinaemia. Prolactin measurement drawn from an indwelling cannula after rest removes stress as a confounding variable. The objective was t...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-014-0576-7

    authors: Whyte MB,Pramodh S,Srikugan L,Gilbert JA,Miell JP,Sherwood RA,McGregor AM,Aylwin SJ

    更新日期:2015-06-01 00:00:00

  • Hematologic neoplasias and acromegaly.

    abstract::We report a 59-year-old acromegalic woman, who presented with generalized bone pain, weakness, fatigue and foamy urine, who was found to have multiple myeloma (MM); and a 60-year-old acromegalic woman with dizziness, vomiting and abdominal pain, high blood pressure and splenomegaly that was posteriorly diagnosed as ha...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-009-0176-0

    authors: Barbosa FR,Vieira Neto L,Lima GA,Wildemberg LE,Portugal R,Gadelha MR

    更新日期:2011-12-01 00:00:00

  • Pathology of prolactinomas: any predictive value?

    abstract::Lactotroph adenomas, also called prolactinomas and prolactin-secreting adenomas, constitute nearly 80% of functioning pituitary tumors and about 30-50% of all adenomas in the clinical practice. Lactotroph adenomas occur in the general population at a prevalence of 45/100,000, are more common in women, but also involve...

    journal_title:Pituitary

    pub_type: 杂志文章,评审

    doi:10.1007/s11102-019-00997-1

    authors: Lopes MBS

    更新日期:2020-02-01 00:00:00

  • Twelve cases of pituitary metastasis: a case series and review of the literature.

    abstract:PURPOSE:The pituitary gland is an unusual site for metastatic spread, but as patients with metastatic malignancy are living longer, it may become more prevalent. Compression of important anatomy adjacent to the sella may produce disabling symptoms and endocrine derangement, leading to significant morbidity. METHODS:An...

    journal_title:Pituitary

    pub_type: 杂志文章,评审

    doi:10.1007/s11102-018-0899-x

    authors: Castle-Kirszbaum M,Goldschlager T,Ho B,Wang YY,King J

    更新日期:2018-10-01 00:00:00

  • A novel variation in the AVP gene resulting in familial neurohypophyseal diabetes insipidus in a large Italian kindred.

    abstract::Familial neurohypophyseal diabetes insipidus (FNDI) is mostly an autosomal dominant inherited disorder presenting with severe polydipsia and polyuria typically in early childhood. To date, 69 different variations in the AVP gene encoding the AVP prohormone have been identified in autosomal dominant FNDI (adFNDI). In t...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-012-0392-x

    authors: Birkegaard C,Christensen JH,Falorni A,Marzotti S,Minarelli V,Gregersen N,Rittig S

    更新日期:2013-06-01 00:00:00

  • Staging and managing patients with acromegaly in clinical practice: baseline data from the SAGIT® validation study.

    abstract:PURPOSE:The SAGIT® instrument, designed to assist clinicians to stage acromegaly, assess treatment response and adapt patient management, was well received by endocrinologists in a pilot study. We report an interim analysis of baseline data from the validation phase. METHODS:The SAGIT® validation study (ClinicalTrials...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-019-00977-5

    authors: Giustina A,Bronstein MD,Chanson P,Petersenn S,Casanueva FF,Sert C,Houchard A,Melmed S

    更新日期:2019-10-01 00:00:00

  • Predictors of endoscopic transsphenoidal surgery outcome in acromegaly: patient and tumor characteristics evaluated by magnetic resonance imaging.

    abstract::The availability of various first-line treatment modalities for acromegaly and evolving surgical techniques emphasize the need for accurately defined predictors of surgical outcome. We retrospectively analysed the outcome of 30 patients with acromegaly after initial endoscopic transsphenoidal surgery in two university...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-012-0395-7

    authors: van Bunderen CC,van Varsseveld NC,Baayen JC,van Furth WR,Aliaga ES,Hazewinkel MJ,Majoie CB,Freling NJ,Lips P,Fliers E,Bisschop PH,Drent ML

    更新日期:2013-06-01 00:00:00

  • Angiographically documented cerebral vasospasm following transsphenoidal surgery for pituitary tumors.

    abstract::Symptomatic cerebral vasospasm (CVS) after transsphenoidal surgery (TSS) is very rare compared with vasospasm resulting from aneurysmal subarachnoid hemorrhage (SAH). Fewer than six cases documented by cerebral angiography have been reported. We evaluated the records of 15 patients in whom SAH developed after TSS. The...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-012-0415-7

    authors: Kim EH,Oh MC,Kim SH

    更新日期:2013-06-01 00:00:00

  • Endoscopic endonasal approach for pituitary adenomas: a series of 555 patients.

    abstract:PURPOSE:To report the results of a consecutive series of patients who underwent an endoscopic endonasal approach (EEA) for resection of a pituitary adenoma and compare them to previous series of microscopic and endoscopic approaches. METHODS:A retrospective review of clinical and radiographic outcomes of a consecutive...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-013-0502-4

    authors: Paluzzi A,Fernandez-Miranda JC,Tonya Stefko S,Challinor S,Snyderman CH,Gardner PA

    更新日期:2014-08-01 00:00:00

  • Roles of insulin-like growth factor-I and growth hormone in mediating insulin resistance in acromegaly.

    abstract::Most patients with acromegaly have some degree of insulin resistance. The principal mediator of insulin resistance in acromegaly is hypersecretion of growth hormone. Growth hormone acts at several levels to block insulin actions including inhibiting phosphorylation of the insulin receptor and one of its principal sign...

    journal_title:Pituitary

    pub_type: 杂志文章,评审

    doi:10.1023/a:1023321421760

    authors: Clemmons DR

    更新日期:2002-01-01 00:00:00

  • Malignant transformation in non-functioning pituitary adenomas (pituitary carcinoma).

    abstract::Non-functioning pituitary carcinomas (NFPC) are defined as tumours of adenophyseal origin with craniospinal or systemic dissemination, with the absence of a hormonal hypersecretion syndrome. These are a histologically heterogenous group of tumours, comprising gonadotroph, null cell, "silent" tumours of corticotroph, s...

    journal_title:Pituitary

    pub_type: 杂志文章,评审

    doi:10.1007/s11102-017-0857-z

    authors: Lenders N,McCormack A

    更新日期:2018-04-01 00:00:00

  • Craniopharyngioma surgery.

    abstract::Ideal surgical treatment of craniopharyngiomas remains a major challenge for neurosurgeons. Craniopharyngiomas grow in the deep-seated hypothalamic area that is paramount for vegetative, emotional and endocrine function, and for maintaining worthwhile life. The benign histological nature of craniopharyngiomas belies t...

    journal_title:Pituitary

    pub_type: 杂志文章,评审

    doi:10.1007/s11102-008-0137-z

    authors: Honegger J,Tatagiba M

    更新日期:2008-01-01 00:00:00