Evaluation and follow-up of patients diagnosed with hypophysitis: a cohort study

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dc.authoridErkan, Buruc/0000-0001-8586-0613
dc.authoridGul, Nurdan/0000-0002-1187-944X
dc.authoridDokmetas, Hatice Sebile/0000-0003-0300-4173
dc.authoridSener, Selcuk yusuf/0000-0003-1340-0997
dc.authoridKadioglu, Pinar/0000-0002-8329-140X
dc.authoridErtorer, Melek Eda/0000-0001-7357-8709
dc.authoridALPHAN UC, ZIYNET/0000-0002-0008-2742
dc.contributor.authorHacioglu, Aysa
dc.contributor.authorKaraca, Zuleyha
dc.contributor.authorUysal, Serhat
dc.contributor.authorOzkaya, Hande Mefkure
dc.contributor.authorKadioglu, Pinar
dc.contributor.authorSelcukbiricik, Ozlem Soyluk
dc.contributor.authorGul, Nurdan
dc.date.accessioned2025-02-22T14:08:54Z
dc.date.available2025-02-22T14:08:54Z
dc.date.issued2024
dc.departmentDicle Üniversitesien_US
dc.description.abstractObjective Primary hypophysitis might be challenging to diagnose, and there is a lack of evidence regarding optimal treatment strategies due to rarity of the disease. We aim to investigate the clinical features and compare the outcomes of different management strategies of primary hypophysitis in a large group of patients recruited on a nationwide basis.Design A retrospective observational study.Methods The demographic, clinical, and radiologic features and follow-up data were collected in study protocol templates and analyzed.Results One hundred and thirteen patients (78.8% female, median age: 36 years) were included. Lymphocytic (46.7%) and granulomatous hypophysitis (35.6%) were the prevailing subtypes out of 45 patients diagnosed after pathologic investigations. Headache (75.8%) was the most common symptom, and central hypogonadism (49.5%) was the most common hormone insufficiency. Of the patients, 52.2% were clinically observed without interventions, 18.6% were started on glucocorticoid therapy, and 29.2% underwent surgery at presentation. Headache, suprasellar extension, and chiasmal compression were more common among glucocorticoid-treated patients than who were observed. Cox regression analysis revealed higher hormonal and radiologic improvement rates in the glucocorticoid-treated group than observation group (hazard ratio, 4.60; 95% CI, 1.62-12.84 and HR, 3.1; 95% CI, 1.40-6.68, respectively). The main indication for surgery was the inability to exclude a pituitary adenoma in the presence of compression symptoms, with a recurrence rate of 9%.Conclusion The rate of spontaneous improvement might justify observation in mild cases. Glucocorticoids proved superior to observation in terms of hormonal and radiologic improvements. Surgery may not be curative and might be considered in indeterminate, treatment-resistant, or severe cases.en_US
dc.identifier.doi10.1093/ejendo/lvae101
dc.identifier.endpage322en_US
dc.identifier.issn0804-4643
dc.identifier.issn1479-683X
dc.identifier.issue3en_US
dc.identifier.pmid39186535en_US
dc.identifier.scopus2-s2.0-85203473895en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage312en_US
dc.identifier.urihttps://doi.org/10.1093/ejendo/lvae101
dc.identifier.urihttps://hdl.handle.net/11468/29705
dc.identifier.volume191en_US
dc.identifier.wosWOS:001307744600001
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoenen_US
dc.publisherOxford Univ Pressen_US
dc.relation.ispartofEuropean Journal of Endocrinologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.snmzKA_WOS_20250222
dc.subjectadrenal insufficiencyen_US
dc.subjecthypogonadismen_US
dc.subjecthypophysitisen_US
dc.subjectglucocorticoidsen_US
dc.subjectobservationen_US
dc.titleEvaluation and follow-up of patients diagnosed with hypophysitis: a cohort studyen_US
dc.typeArticleen_US

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