Revisitation of autoimmune hypophysitis: knowledge and uncertainties on pathophysiological and clinical aspects
| العنوان: | Revisitation of autoimmune hypophysitis: knowledge and uncertainties on pathophysiological and clinical aspects |
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| المؤلفون: | Dario Giugliano, Katherine Esposito, Giuseppe Bellastella, Annamaria De Bellis, Antonio Bellastella, Antonio Bizzarro, Maria Ida Maiorino |
| المساهمون: | Bellastella, Giuseppe, Maiorino, Mi, Bizzarro, Antonio, Giugliano, Dario, Esposito, Katherine, Bellastella, Antonio, DE BELLIS, Annamaria |
| المصدر: | Pituitary |
| بيانات النشر: | Springer US, 2016. |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | medicine.medical_specialty, Hypophysitis, Endocrinology, Diabetes and Metabolism, Autoimmune hypophysitis, 030209 endocrinology & metabolism, Disease, Article, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, HLA Antigens, Biopsy, IgG4 plasmacytic hypophysiti, medicine, DIAGNOSTIC STANDARD, Humans, CTLA-4 Antigen, Intensive care medicine, Autoimmune hypophysiti, medicine.diagnostic_test, business.industry, Antibodies, Monoclonal, Magnetic resonance imaging, Lymphocytic hypophysitis, Antipituitary antibodies, medicine.disease, Pathophysiology, Lymphocytic hypophysiti, Immunoglobulin G, Pituitary Gland, Immunology, business, Antipituitary antibodie, 030217 neurology & neurosurgery, IgG4 plasmacytic hypophysitis |
| الوصف: | Purpose: This publication reviews the accepted knowledges and the findings still discussed on several features of autoimmune hypophysitis, including the most recently described forms, such as IgG4 and cancer immunotherapy- related hypophysitis. Methods: The most characteristic findings and the pending controversies were derived from a literature review and previous personal experiences. A single paragraph focused on some atypical examples of the disease presenting under confounding pretences. Results: Headache, visual field alterations and impaired pituitary secretion are the most frequent clinical findings of the disease. Pituitary biopsy, still considered the gold diagnostic standard, does not always receive consent from the patients. The role of magnetic resonance imaging is limited, as this disease may generate images similar to those of other diseases. The role of antipituitary and antihypothalamus antibodies is still discussed owing to methodological difficulties and also because the findings on the true pituitary antigen(s) are still debated. However, the low sensitivity and specificity of immunofluorescence, one of the more widely employed methods to detect these antibodies, may be improved, considering a predetermined cut-off titre and a particular kind of immunostaining. Conclusion: Autoimmune hypophysitis is a multifaceted disease, which may certainly be diagnosed by pituitary biopsy. However, the possible different clinical, laboratory and imaging features must be considered by the physician to avoid a misdiagnosis when examining a possibly affected patient. Therapeutic choice has to be made taking into account the clinical conditions and the degree of hypothalamic-pituitary involvement, but also considering that spontaneous remissions can occur. |
| اللغة: | English |
| تدمد: | 1573-7403 1386-341X |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::90cd940de699040ac29dba12e8b30481Test http://europepmc.org/articles/PMC7088540Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....90cd940de699040ac29dba12e8b30481 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15737403 1386341X |
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