• Journal of Korean Neurosurgical Society
• /
• v.42 no.3
• /
• pp.216-219
• /
• 2007

Lymphocytic hypophysitis is a clinically rare disease, and it has been known to be an autoimmune disease which mainly affects pregnant women at the end of gestation or right after delivery. The authors experienced a case of lymphocytic hypophysitis in a 29-year-old pregnant woman with rapid progressing visual disturbance. Sella MRI showed a mass-like lesion of hypophysis and hypertrophy of pituitary stalk with evidences of hypopituitarism. Cesarean section was done and then TSA was performed. The pathologic diagnosis was lymphocytic hypophysitis. After TSA, visual acuity was improved and visual field defect was recovered. She was given thyroid hormone replacement therapy because of transient partial hypopituitarism for 6 months after surgery. One must consider the probability of lymphocytic hypophysitis, if there are alteration of visual acuity and visual field defect which aggravate rapidly during pregnancy due to mass effect, decreased serum hormonal levels shown in hypopituitarism and sella MRI findings of hypertrophy of pituitary stalk and enlargement of pituitary gland.

• Journal of Korean Neurosurgical Society
• /
• v.41 no.4
• /
• pp.255-257
• /
• 2007

Lymphocytic hypophysitis [LH] is characterized by lymphocytic pituitary infiltration, which occurs mostly during or after pregnancy. Its involvement in male is very rare. The authors report herein a LH mimicking pituitary macroadenoma-clinically and radiologically in male patient who presented with visual disturbance and hypogonadism.

• Journal of Korean Neurosurgical Society
• /
• v.41 no.1
• /
• pp.50-52
• /
• 2007

Lymphocytic hypophysitis is a rare inflammatory disease of the pituitary gland that is one of the cause of hypopituitarism. The majority of cases occur in women during the peripartum period, and it is rare in men. Testicular feminization syndrome is a genetic disorder presenting a 46XY karyotype, but a normal female phenotype. We report a case of lymphocytic hypophysitis in a 23-year-old woman with testicular feminization syndrome.

• The Korean journal of internal medicine
• /
• v.39 no.5
• /
• pp.801-812
• /
• 2024

Background/Aims: Immune checkpoint inhibitors (ICIs) can induce immune-related adverse events, including endocrine dysfunctions, which can have serious consequences on patient health and quality of life. The clinical course and characteristics of immune-related hypophysitis (irH) are not well established. This study aimed to analyze the clinical course and characteristics of irH. Methods: This single-center, retrospective study analyzed data from electronic medical records of Asan Medical Center, spanning January 2017 through June 2021. It included adult patients with solid tumors who underwent thyroid and adrenal function tests, along with gonadotropin and/or growth hormone evaluations, following the initiation of ICI treatment within the same period. The study explored the clinical characteristics of ICI-treated patients with and without irH, the incidence of irH, the time to irH onset, and the associated hormonal changes. Results: Twenty-one patients were included in this analysis. Clinical characteristics did not differ significantly between the irH (n = 13) and non-irH (n = 8) groups. Deficiency rates in the irH group were 23.1% for thyroid-stimulating hormone (n = 3), 76.9% for adrenocorticotropic hormone (n = 10), 61.5% for gonadotropin (n = 8), and 15.4% for growth hormone (n = 2). The overall incidence was 0.9 per person-year, with 6-month and 1-year cumulative incidences of 38.8% and 57.1%, respectively. The median time from ICI initiation to irH diagnosis was 7.7 months. Time to levothyroxine replacement was shorter in the irH group. Conclusions: The findings provide evidence that could facilitate the prediction of ICI-induced irH based on clinical course and characteristics.

• IMMUNE NETWORK
• /
• v.20 no.1
• /
• pp.9.1-9.21
• /
• 2020

Immune checkpoint inhibitors (ICIs) have been changing the paradigm of cancer treatment. However, immune-related adverse effects (irAEs) have also increased with the exponential increase in the use of ICIs. ICIs can break up the immunologic homeostasis and reduce T-cell tolerance. Therefore, inhibition of immune checkpoint can lead to the activation of autoreactive T-cells, resulting in various irAEs similar to autoimmune diseases. Gastrointestinal toxicity, endocrine toxicity, and dermatologic toxicity are common side effects. Neurotoxicity, cardiotoxicity, and pulmonary toxicity are relatively rare but can be fatal. ICI-related gastrointestinal toxicity, dermatologic toxicity, and hypophysitis are more common with anti- CTLA-4 agents. ICI-related pulmonary toxicity, thyroid dysfunction, and myasthenia gravis are more common with PD-1/PD-L1 inhibitors. Treatment with systemic steroids is the principal strategy against irAEs. The use of immune-modulatory agents should be considered in case of no response to the steroid therapy. Treatment under the supervision of multidisciplinary specialists is also essential, because the symptoms and treatments of irAEs could involve many organs. Thus, this review focuses on the mechanism, clinical presentation, incidence, and treatment of various irAEs.

• Korean Journal of Radiology
• /
• v.2 no.4
• /
• pp.222-230
• /
• 2001

Central diabetes insipidus (DI) can be the outcome of a number of diseases that affect the hypothalamic-neurohypophyseal axis. The causes of the condition can be classified as traumatic, inflammatory, or neoplastic. Traumatic causes include postoperative sella or transection of the pituitary stalk, while infectious or inflammatory causes include meningitis, lymphocytic hypophysitis, and granulomatous inflammations such as sarcoidosis and Wegener's granulomatosis. Various neoplastic conditions such as germinoma, Langerhans cell histiocytosis, metastasis, leukemic infiltration, lymphoma, teratoma, pituitary adenoma, craniopharyngioma, Rathke cleft cyst, hypothalamic glioma, and meningioma are also causes of central DI. In affected patients, careful analysis of these MR imaging features and correlation with the clinical manifestations can allow a more specific diagnosis, which is essential for treatment.