Differential diagnosis and tactics of managing a patient with primary hypophysitis on the example of a clinical case
https://doi.org/10.14341/probl13311
Abstract
In recent years, there has been a significant increase in the prevalence of autoimmune endocrinopathies, which are known to affect various levels of the endocrine system, including the pituitary gland. Hypophysitis is a general term used to describe any form of sellar and suprasellar inflammation that leads to structural changes in the hypothalamic-pituitary region and manifests itself in varying degrees of hormonal deficiency of the anterior and posterior pituitary glands. To date, there is a primary form of hypophysitis, which occurs as a result of an autoimmune lesion directly to the pituitary gland, and a secondary form of hypophysitis, which occurs as a result of the presence of a systemic autoimmune disease. Regardless of the etiology, patients with hypophysitis show various signs and symptoms caused by an inflammatory process in the pituitary gland, which can lead to the development of hypopituitarism, compression of the sellar and parasellar structures. MRI is currently the best non-invasive diagnostic tool for diagnosing hypopituitarism, however, the diagnosis can be made with certainty only by histological examination of the pituitary tissue, which requires an invasive approach, which greatly reduces the feasibility of this procedure. In this article, we present a patient with MRI showing signs of hypophysitis in the absence of clear clinical symptoms.
About the Authors
N. N. Katamadze
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Nino N. Katamadze – MD.
Dmitry Ulyanova street 11, 117036 Moscow
Competing Interests:
none
A. A. Tskaeva
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Alla A. Tskaeva
Moscow
Competing Interests:
none
E. A. Pigarova
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Ekaterina A. Pigarova - MD, PhD.
Moscow
Competing Interests:
none
L. K. Dzeranova
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Larisa K. Dzeranova - ScD.
Moscow
Competing Interests:
none
N. V. Tarbaeva
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Natalya V. Tarbaeva - PhD.
Moscow
Competing Interests:
none
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Supplementary files
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1. Figure 1. MR image of the patient's chiasmal-sellar region. Sagittal and frontal sections. | |
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2. Figure 2. MR image of the patient's chiasmal-sellar region. Sagittal and frontal sections. | |
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| Type | Исследовательские инструменты | |
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Katamadze N.N., Tskaeva A.A., Pigarova E.A., Dzeranova L.K., Tarbaeva N.V. Differential diagnosis and tactics of managing a patient with primary hypophysitis on the example of a clinical case. Problems of Endocrinology. 2023;69(6):54-62. (In Russ.) https://doi.org/10.14341/probl13311
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