The Diagnosis and Management of Lymphocytic Hypophysitis

Sherry L Iuliano; Edward R Laws

Disclosures

Expert Rev Endocrinol Metab. 2011;6(6):777-783. 

In This Article

Discussion

The case illustrations demonstrate a wide spectrum of presentation, imaging results and treatment strategies. Debate will continue as to whether lymphocytic hypophysitis is in fact a type of autoimmune phenomenon. Although the inflammatory process is relatively well stereotyped, there are many variations in the extent and character of the pathologic process. Not surprisingly, there is also variation in the response to therapy, in particular to corticosteroids. Those patients who have partial responses and relapses continue to represent therapeutic challenges. Longitudinal follow-up and diligent anterior and posterior pituitary replacement therapy are essential for successful management of lymphocytic hypophysitis. Routine pituitary laboratory studies and periodic repeat MRI scans should be part of the long-term plan.

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