Evaluation and follow-up of patients diagnosed with hypophysitis: a cohort study

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dc.authoridKadioglu, Pinar/0000-0002-8329-140X
dc.authoridErkan, Buruc/0000-0001-8586-0613
dc.authoridErtorer, Melek Eda/0000-0001-7357-8709
dc.contributor.authorHacioglu, Aysa
dc.contributor.authorKaraca, Zuleyha
dc.contributor.authorUysal, Serhat
dc.contributor.authorOzkaya, Hande Mefkure
dc.contributor.authorKadioglu, Pinar
dc.contributor.authorSelcukbiricik, Ozlem Soyluk
dc.contributor.authorGul, Nurdan
dc.date.accessioned2024-10-29T17:58:38Z
dc.date.available2024-10-29T17:58:38Z
dc.date.issued2024
dc.departmentTekirdağ Namık Kemal Üniversitesi
dc.description.abstractObjective Primary hypophysitis might be challenging to diagnose, and there is a lack of evidence regarding optimal treatment strategies due to rarity of the disease. We aim to investigate the clinical features and compare the outcomes of different management strategies of primary hypophysitis in a large group of patients recruited on a nationwide basis.Design A retrospective observational study.Methods The demographic, clinical, and radiologic features and follow-up data were collected in study protocol templates and analyzed.Results One hundred and thirteen patients (78.8% female, median age: 36 years) were included. Lymphocytic (46.7%) and granulomatous hypophysitis (35.6%) were the prevailing subtypes out of 45 patients diagnosed after pathologic investigations. Headache (75.8%) was the most common symptom, and central hypogonadism (49.5%) was the most common hormone insufficiency. Of the patients, 52.2% were clinically observed without interventions, 18.6% were started on glucocorticoid therapy, and 29.2% underwent surgery at presentation. Headache, suprasellar extension, and chiasmal compression were more common among glucocorticoid-treated patients than who were observed. Cox regression analysis revealed higher hormonal and radiologic improvement rates in the glucocorticoid-treated group than observation group (hazard ratio, 4.60; 95% CI, 1.62-12.84 and HR, 3.1; 95% CI, 1.40-6.68, respectively). The main indication for surgery was the inability to exclude a pituitary adenoma in the presence of compression symptoms, with a recurrence rate of 9%.Conclusion The rate of spontaneous improvement might justify observation in mild cases. Glucocorticoids proved superior to observation in terms of hormonal and radiologic improvements. Surgery may not be curative and might be considered in indeterminate, treatment-resistant, or severe cases.
dc.identifier.doi10.1093/ejendo/lvae101
dc.identifier.endpage322
dc.identifier.issn0804-4643
dc.identifier.issn1479-683X
dc.identifier.issue3en_US
dc.identifier.pmid39186535
dc.identifier.scopus2-s2.0-85203473895
dc.identifier.scopusqualityQ1
dc.identifier.startpage312
dc.identifier.urihttps://doi.org/10.1093/ejendo/lvae101
dc.identifier.urihttps://hdl.handle.net/20.500.11776/14431
dc.identifier.volume191
dc.identifier.wosWOS:001307744600001
dc.identifier.wosqualityN/A
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherOxford Univ Press
dc.relation.ispartofEuropean Journal of Endocrinology
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectadrenal insufficiency
dc.subjecthypogonadism
dc.subjecthypophysitis
dc.subjectglucocorticoids
dc.subjectobservation
dc.titleEvaluation and follow-up of patients diagnosed with hypophysitis: a cohort study
dc.typeArticle

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