Search results for "Hypophysitis"
showing 7 items of 7 documents
In Situ Activation of Pituitary-Infiltrating T Lymphocytes in Autoimmune Hypophysitis
2017
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 …
Endocrine side-effects of new anticancer therapies: Overall monitoring and conclusions
2018
IF 0.795 (2017); International audience; The present final consensus statement of the French Society of Endocrinology lays out the assessments that are to be systematically performed before and during anticancer treatment by immunotherapy, tyrosine kinase inhibitors or mTOR inhibitors, even without onset of any endocrinopathy. It also discusses the CTCAE adverse event grading system in oncology and the difficulty of implementing it for endocrine side-effects of these anticancer treatments. Notably, this is why certain treatment steps applied in other side-effects (e.g., high-dose corticosteroids, contraindications to immunotherapy, etc.) need to be discussed before implementation for endocr…
French Endocrine Society Guidance on endocrine side effects of immunotherapy.
2018
The management of cancer patients has changed due to the considerably more frequent use of immune checkpoint inhibitors (ICPIs). However, the use of ICPI has a risk of side effects, particularly endocrine toxicity. Since the indications for ICPI are constantly expanding due to their efficacy, it is important that endocrinologists and oncologists know how to look for this type of toxicity and how to treat it when it arises. In view of this, the French Endocrine Society initiated the formulation of a consensus document on ICPI-related endocrine toxicity. In this paper, we will introduce data on the general pathophysiology of endocrine toxicity, and we will then outline expert opinion focusing…
Autoimmune Hypophysitis
2014
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…
Inflammatory pituitary lesions
2021
Abstract Inflammatory pituitary lesions are rare but important differential diagnoses of nonfunctioning pituitary masses. Primary hypophysitis as an autoimmune disorder has received increasing attention over the past decades. In the last decade, immune checkpoint inhibitor–induced hypophysitis has emerged as a new type of secondary hypophysitis. Various pituitary tumors may also cause secondary hypophysitis. Systemic, noninfectious granulomatous diseases that can involve the pituitary region include sarcoidosis, granulomatosis with polyangiitis, Langerhans cell histiocytosis, Erdheim-Chester disease, and Rosai-Dorfman disease. Furthermore, infectious diseases can affect the pituitary gland.…
Use of a clinicoradiological score to determine the presurgical diagnosis of autoimmune hypophysitis in a teenage girl.
2013
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…
2018 Consensus of the French Society of Endocrinology: endocrine toxicities of cancer immunotherapies
2019
Immunotherapy induced side effects: Are frequent, usually well-tolerated, and can lead to thyroid, pituitary, and less frequently adrenals and pancreas (fulminant diabetes) disease,. Do not contra-indicate immunotherapy, and rarely require high dose glucocorticoids; Need to be screened for, as there are acute manifestations, and replacement treatments can be given lifelong; Require a pre-immunotherapy evaluation; Require a careful follow-up at least during the first 6 months of immunotherapy.