0000000000343877
AUTHOR
Patrizio Caturegli
In Situ Activation of Pituitary-Infiltrating T Lymphocytes in Autoimmune Hypophysitis
AbstractAutoimmune hypophysitis (AH) is a chronic inflammatory disease characterized by infiltration of T and B lymphocytes in the pituitary gland. The mechanisms through which infiltrating lymphocytes cause disease remain unknown. Using a mouse model of AH we assessed whether T lymphocytes undergo activation in the pituitary gland. Infiltrating T cells co-localized with dendritic cells in the pituitary and produced increased levels of interferon-γ and interleukin-17 upon stimulation in vitro. Assessing proliferation of CD3- and B220-postive lymphocytes by double immunohistochemistry (PCNA-staining) and flow cytometry (BrdU incorporation) revealed that a discrete proportion of infiltrating …
Use of a clinicoradiological score to determine the presurgical diagnosis of autoimmune hypophysitis in a teenage girl.
The distinction between autoimmune hypophysitis and other non–hormone secreting pituitary masses is often difficult to determine with certainty without pituitary biopsy and pathological examination. To aid in this distinction, the authors recently published a clinicoradiological scoring system, which they used in the case of a 15-year-old girl presented here. The patient presented with headache, visual field defects, polydipsia, and polyuria, and she was found to have secondary hypogonadism and hypoadrenalism. Magnetic resonance imaging showed a pituitary mass of approximately 2 cm in diameter. Application of the clinicoradiological parameters gave a score of −6, which favored a diagnosis o…
Autoimmune Hypophysitis
Autoimmune hypophysitis is a chronic inflammation of the pituitary gland that can be classified according to anatomic location, histopathology, or cause. Location differentiates hypophysitis into adenohypophysitis, infundibulo-neurohypophysitis, or panhypophysitis depending on whether the clinical and radiological signs (and pathological findings if available) involve the anterior lobe, the posterior lobe and the stalk, or both structures. Histopathology identifies two main forms of hypophysitis, lymphocytic and granulomatous, as well as xanthomatous, IgG4 plasmacytic, and necrotizing variants. Etiology distinguishes primary and secondary hypophysitis. Primary hypophysitis refers to the cas…