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Pituitary autoimmunity

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Endocrine Autoimmunity and Associated Conditions

Part of the book series: Immunology and Medicine Series ((IMME,volume 27))

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Abstract

Lymphocytic hypophysitis is one of a number of different disorders affecting the pituitary gland to which has been ascribed a possible autoimmune pathogenesis. The condition was first recognized in an autopsy specimen by Goudie and Pinkerton in 1962 [1]. It soon became considered to be an autoimmune disorder, partly on account of its frequent association with other classical autoimmune disorders associated with organ specific antibodies [2], particularly thyroiditis. With over 80 cases now described it is clear that the inflammatory process is typically confined to the adenohypophysitis, more accurately termed lymphocytic adenohypophysitis, and the condition occurs mostly, but not exclusively, in the peripartum period.

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References

  1. Goudie RB, Pinkerton PH. Anterior hypophysitis and Hashimoto’s disease in a young woman. J Pathol Bacteriol. 1962;83:584–585.

    Article  PubMed  CAS  Google Scholar 

  2. Patel MC, Guneratne N, Haq N, West TET, Weetman AP, Clayton RN. Peripartum hypopituitarism and lymphocytic hypophysitis. Q J Med. 1995;88:571–580.

    CAS  Google Scholar 

  3. Anonymous. Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 25. New Engl J Med. 1995;333:441–447.

    Google Scholar 

  4. Imura H, Nakao K, Shimatsu A et al. Lymphocytic infundibuloneurohypophysitis as a cause of central diabetes insipidus. New Engl J Med. 1993;329:683–689.

    Article  PubMed  CAS  Google Scholar 

  5. Cosman F, Post KD, Holub DA, Wardlaw SL. Lymphocytic hypophysitis. Report of three new cases and review of the literature. Medicine. 1989;68:240–256.

    Article  PubMed  CAS  Google Scholar 

  6. Quencer RM. Lymphocytic adenohypophysitis: autoimmune disorder of the pituitary gland. Am J Neuroradiol. 1980;1:343–345.

    PubMed  CAS  Google Scholar 

  7. Guay AT, Agnello V, Tronic BC, Gresham DG, Freidberg SR. Lymphocytic hypophysitis in a man. J Clin Endocrinol Metab. 1987;64:631–634.

    Article  PubMed  CAS  Google Scholar 

  8. Jenkins PJ, Chew SL, Lowe DG et al. Lymphocytic hypophysitis: unusual features of a rare condition. Clin Endocrinol. 1995;42:529–534.

    Article  CAS  Google Scholar 

  9. Bevan JS, Othman S, Lazarus JH, Parkes AB, Hall R. Reversible adrenocorticotropin deficiency due to probable autoimmune hypophysitis in a woman with postpartum thyroiditis. J Clin Endocrinol Metab. 1992;74:548–552.

    Article  PubMed  CAS  Google Scholar 

  10. Gal R, Schwartz A, Gukovsky-Oren S, Peleg D, Goldman J, Kessler E. Lymphoid hypophysitis associated with sudden maternal death: report of a case and review of the literature. Obstet Gynecol Surv. 1986;41:619–621.

    PubMed  CAS  Google Scholar 

  11. Scheithauer BW, Sano T, Kovacs KT, Young WF, Ryan N, Randall RV. The pituitary gland in pregnancy: a clinicopathological and immunohistochemical study of 69 cases. Mayo Clin Proc. 1990;65:461–474.

    Article  PubMed  CAS  Google Scholar 

  12. Gonzalez JG, Elizondo G, Saldivar E, Nanez H, Todd LE, Vallarreal JZ. Pituitary gland growth during normal pregnancy: an in vivo study using magnetic resonance imaging. Am J Med. 1988;85:217–220.

    Article  PubMed  CAS  Google Scholar 

  13. Nishioka H, Ito H, Miki T, Akada K. A case of lymphocytic hypophysitis with massive fibrosis and the role of surgical intervention. Surg Neurol. 1994;42:74–78.

    Article  PubMed  CAS  Google Scholar 

  14. Pestell RG, Best JD, Alford FP. Lymphocytic hypophysitis. The clinical spectrum of the disorder and evidence for an autoimmune pathogenesis. Clin Endocrinol. 1990;33:457–466.

    Article  CAS  Google Scholar 

  15. Nussbaum CE, Okawara SH, Jacobs LS. Lymphocytic hypophysitis with involvement of the cavernous sinus and hypothalamus. Neurosurgery. 1991;28:440–444.

    Article  PubMed  CAS  Google Scholar 

  16. Supler ML, Mickle JP. Lymphocytic hypophysitis. Report of a case in a man with cavernous sinus involvement. Surg Neurol. 1992;37:472–476.

    Article  PubMed  CAS  Google Scholar 

  17. Lee JH, Laws ER, Guthrie BL, Dina TS, Nochomovitz LE. Lymphocytic hypophysitis: occurrence in two men. Neurosurgery. 1994;34:159–163.

    Article  PubMed  CAS  Google Scholar 

  18. Escobar-Morreale H, Serrano-Gotarredona J, Varela C. Isolated adrenocorticotropic hormone deficiency due to probable lymphocytic hypophysitis in a man. J Endocrinol Invest 1994;17:127–131.

    PubMed  CAS  Google Scholar 

  19. Abe T, Matsumoto K, Sanno N. Osamura Y. Lymphocytic hypophysitis. Case report Neurosurgery. 1995;36:1016–1019.

    Article  CAS  Google Scholar 

  20. Thodou E, Asa SL, Kontogeorgos G, Kovacs K, Horvath E, Ezzat S. Clinical case seminar: lymphocytic hypophysitis: clinicopathological findings. J Clin Endocrinol Metab, 1995;80:2302–2311.

    Article  PubMed  CAS  Google Scholar 

  21. Paja M, Estrada A, Ojeda A, Ramon y Cajal S, Garcia-Uria J, Lucas T Lymphocytic hypophysitis causing hypopituitarism and diabetes insipidus, and associated with autoimmune thyroiditis, in a non-pregnant woman. Postgrad Med J. 1994;70:220–224

    Article  PubMed  CAS  Google Scholar 

  22. Portocarrero CJ, Robinson AG, Taylor AL, Klein I. Lymphoid hypophysitis an unusual case of hyperprolactinaemia and enlarged sella turcica. J Am Med Assoc. 1981;246:1811–1812.

    Article  CAS  Google Scholar 

  23. Hughes JM, Ellsworth CA, Harris BS. Clinical case seminar: a 33-year-old woman with a pituitary mass and panhypopituitarism. J Clin Endocrinol Metab. 1995;80:1521–1525.

    Article  PubMed  CAS  Google Scholar 

  24. Levine SN, Benzel EC, Fowler MR, Shroyer JV III, Mirfakhraee M. Lymphocytic adenohypophysitis: clinical, radiological, and magnetic resonance imaging characterization Neurosurgery. 1988;22:937–941.

    Article  PubMed  CAS  Google Scholar 

  25. Ahmadi J, Meyers GS, Segall HD, Sharma OP, Hinton DR. Lymphocytic adenohypophysitis: contrast-enhanced MR imaging in five cases. Radiology. 1995;195:30–34.

    PubMed  CAS  Google Scholar 

  26. Naik RG, Ammini A, Shah P, Sarkar C, Mehta VS, Berry M. Lymphocytic hypophysitis. Case report. J Neurosurg. 1994;80:925–927.

    Article  PubMed  CAS  Google Scholar 

  27. Asa SL, Bilbao JM, Kovacs K, Josse RG, Kreines K. Lymphocytic hypophysitis of pregnancy resulting in hypopituitarism: a distinct clinicopathological entity. Ann Intern Med. 1981;95:166–171.

    Article  PubMed  CAS  Google Scholar 

  28. Powrie JK, Powell M, Ayers AB, Lowy C, Sonksen PH. Lymphocytic adenohypophysitis: magnetic resonance imaging features of two new cases and a review of the literature. Clin Endocrinol. 1995;42:315–322.

    Article  CAS  Google Scholar 

  29. Beressi N, Cohen R, Beressi J et al. Pseudotumoural lymphocytic hypophysitis successfully treated by corticosteroid alone: first case report. Neurosurgery. 1994;35:505–508.

    Article  PubMed  CAS  Google Scholar 

  30. Castle D, De Villiers JC, Melvill R. Lymphocytic adenohypophysitis. Report of a case with demonstration of spontaneous tumour regression and a review of the literature. Br J Neurosurg. 1988;2:401–406.

    Article  PubMed  CAS  Google Scholar 

  31. Bitton RN, Slavin M, Decker RE, Zito J, Schneider BS. The course of lymphocytic hypophysitis. Surg Neurol. 1991;36:40–43.

    Article  PubMed  CAS  Google Scholar 

  32. McGrail KM, Beyerl BD, Black PM, Klibanski A, Zervas NT. Lymphocytic adenohypophysitis of pregnancy with complete recovery. Neurosurgery. 1987;20:791–793.

    Article  PubMed  CAS  Google Scholar 

  33. Ozawa Y, Shishiba Y. Recovery from lymphocytic hypophysitis associated with painless thyroiditis: clinical implications of circulating antipituitary antibodies. Acta Endocrinol. 1993;128:493–498.

    PubMed  CAS  Google Scholar 

  34. Sautner D, Saeger W, Ludecke DK, Jansen V, Puchner MJ. Hypophysitis in surgical and autoptical specimens. Acta Neuropathol. 1995;90:637–644.

    Article  PubMed  CAS  Google Scholar 

  35. Bevan JS, Burke CW, Esiri MM, Adams CBT. Misinterpretation of prolactin levels leading to management errors in patients with sellar enlargement. Am J Med. 1987;82:29–32.

    Article  PubMed  CAS  Google Scholar 

  36. Ahmed SR, Aiello DP, Page R, Hopper K, Towfighi J, Santen RJ. Necrotizing infundibulohypophysitis: a unique syndrome of diabetes insipidus and hypopituitarism. J Clin Endocrinol Metab. 1993;76:1499–1504.

    Article  PubMed  CAS  Google Scholar 

  37. McConnon JK, Smyth HS, Horvath E. A case of sparsely granulated growth hormone cell adenoma associated with lymphocytic hypophysitis. J Endocrinol Invest. 1991;14:691–696.

    PubMed  CAS  Google Scholar 

  38. Jones TH. Interleukin-6 an endocrine cytokine. Clin Endocrinol. 1994;40:703–713.

    Article  CAS  Google Scholar 

  39. Pouplard A, Bottazzo G, Doniach D, Roitt M. Binding of human immunoglobulins to pituitary ACTH cells. Nature. 1976;261:142–144.

    Article  PubMed  CAS  Google Scholar 

  40. Scherbaum WA, Schrell U, Gluck M, Fahlbusch R, Pfeiffer EF. Autoantibodies to pituitary corticotropin-producing cells: possible marker for unfavourable outcome after pituitary microsurgery for Cushing’s disease. Lancet. 1987;1:1394–1398.

    Article  PubMed  CAS  Google Scholar 

  41. Sauter NP, Toni R, McLaughlin CD, Dyess EM, Kritzman J, Lechan RM. Isolated ACTH deficiency associated with an autoantibody to a corticotroph antigen that is not ACTH or other proopiomelanocortin-derived peptides. J Clin Endocrinol Metab. 1990;70:1391–1397.

    Article  PubMed  CAS  Google Scholar 

  42. Crock P, Salvi M, Miller A, Wall J, Guyda H. Detection of anti-pituitary autoantibodies by immunoblotting. J Immunol Methods. 1993;162:31–40.

    Article  PubMed  CAS  Google Scholar 

  43. Engelberth O, Jezkova Z. Autoantibodies in Sheehan’s syndrome. Lancet. 1965;1:1075.

    Article  Google Scholar 

  44. Komatsu M, Kondo T, Yamauchi et al. Antipituitary antibodies in patients with the primary empty sella syndrome. J Clin Endocrinol Metab. 1988;67:633–638.

    Article  PubMed  CAS  Google Scholar 

  45. Kajita K, Yasuda K, Yamakita N et al. Anti-pituitary antibodies in patients with hypopituitarism and their families: longitudinal observation. Endocrinol Japon. 1991;38:121–129.

    Article  CAS  Google Scholar 

  46. Mayfield RK, Levine JH, Gordon L, Powers J, Galbraith RM, Rawe SE. Lymphoid adenohypophysitis presenting as a pituitary tumour. Am J Med. 1980;69:619–623.

    PubMed  CAS  Google Scholar 

  47. Yoon JW, Choi DS, Liang HC et al. Induction of an organ-specific autoimmune disease, lymphocytic hypophysitis, in hamsters by recombinant rubella virus glycoprotein and prevention of disease by neonatal thymectomy. J Virol. 1992;66:1210–1214.

    PubMed  CAS  Google Scholar 

  48. McCutcheon IE, Oldfield EH. Lymphocytic adenohypophysitis presenting as infertility. J Neurosurg. 1991;74:821–826.

    Article  PubMed  CAS  Google Scholar 

  49. Jansson R, Dahlberg PA, Karlsson FA. Postpartum thyroiditis. In: Lazarus JH, Hall R, eds. Hypothyroidism and Goitre. Baillière’s Clin Endocrinol Metab. 1988;2:619–635.

    Google Scholar 

  50. Levine S. Allergic adenohypophysitis: new experimental disease of the pituitary gland. Science. 1967;158:1190–1191.

    Article  PubMed  CAS  Google Scholar 

  51. Klein I, Kraus KE, Martines AJ, Weber S. Evidence for cellular mediated immunity in an animal model of autoimmune pituitary disease. Endocr Res Comm. 1982;9:145–153.

    Article  CAS  Google Scholar 

  52. Nishiyama S, Takano T, Hidaka Y, Takada K, Iwatani Y, Amino N. A case of postpartum hypopituitarism associated with empty sella; possible relation to postpartum autoimmune hypophysitis. Endocrine J. 1993;40:431–438.

    Article  CAS  Google Scholar 

  53. Mau M, Phillips TM, Ratner RE. Presence of anti-pituitary hormone antibodies in patients with empty sella syndrome and pituitary tumours. Clin Endocrinol. 1993;38:495–500.

    Article  CAS  Google Scholar 

  54. Scherbaum WA, Bottazzo GF. Autoantibodies to vasopressin cells in idiopathic diabetes insipidus: evidence for an autoimmune variant. Lancet. 1983;i:897–901.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Endocrinology, Aberdeen Royal Infirmary Foresterhill, Aberdeen, AB25 2ZN, UK

    H. A. Sawers & J. S. Bevan

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  1. H. A. Sawers
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  2. J. S. Bevan
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Editors and Affiliations

  1. Department of Medicine Clinical Sciences Centre, University of Sheffield Northern General Hospital, Sheffield, S5 7AU, UK

    A. P. Weetman

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© 1998 Springer Science+Business Media Dordrecht

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Sawers, H.A., Bevan, J.S. (1998). Pituitary autoimmunity. In: Weetman, A.P. (eds) Endocrine Autoimmunity and Associated Conditions. Immunology and Medicine Series, vol 27. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-5044-6_11

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  • DOI: https://doi.org/10.1007/978-94-011-5044-6_11

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-6118-6

  • Online ISBN: 978-94-011-5044-6

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