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Infiltrative and Inflammatory Disorders of the Hypothalamus and Pituitary

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Pituitary Disorders throughout the Life Cycle

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Abstract

Hypophysitis is a rare disorder that results in inflammation of the pituitary gland. This can lead to hormonal dysfunction, pituitary enlargement, and mass effect. Hypophysitis can be primary or secondary. Etiologies include autoimmune (lymphocytic, IgG4), granulomatous (sarcoid, Langerhans, idiopathic, Erdheim-Chester Disease, granulomatosis with polyangiitis), xanthomatous hypophysitis, necrotizing hypophysitis, infiltrative (iron overload, amyloidosis), and infectious (bacterial abscess, tuberculosis, syphilis, viral, and parasitic). Determining the cause of hypophysitis is challenging as clinical presentation and imaging findings can mimic other pituitary disorders. Diagnosis often relies on pathology, and histological criteria often overlap between hypophysitis subtypes. Determining an etiology is important; therapy selection (glucocorticoids, immunosuppressive agents, chemotherapy, antibiotics, and/or surgery), long-term monitoring, and determining need for hormone replacement should be considered.

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Acknowledgements

The authors thank Shirley McCartney, PhD, (Oregon Health & Science University) for editorial assistance.

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No funding was received for this work.

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SF and EV have no conflicts to report.

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Authors and Affiliations

  1. Division of Endocrinology, Portland Veterans Affairs Medical Center, Portland, OR, USA

    Stuti Fernandes

  2. Department of Medicine (Endocrinology, Diabetes and Clinical Nutrition), Oregon Health & Science University, Portland, OR, USA

    Stuti Fernandes & Elena V. Varlamov

  3. Department of Neurological Surgery, Oregon Health & Science University, Portland, OR, USA

    Elena V. Varlamov

  4. Pituitary Center, Oregon Health & Science University, Portland, OR, USA

    Elena V. Varlamov

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  1. Stuti Fernandes
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Correspondence to Elena V. Varlamov .

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Editors and Affiliations

  1. Mayo Clinic, Jacksonville, FL, USA

    Susan L. Samson

  2. Emory University School of Medicine, Atlanta, GA, USA

    Adriana G. Ioachimescu

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Fernandes, S., Varlamov, E.V. (2022). Infiltrative and Inflammatory Disorders of the Hypothalamus and Pituitary. In: Samson, S.L., Ioachimescu, A.G. (eds) Pituitary Disorders throughout the Life Cycle. Springer, Cham. https://doi.org/10.1007/978-3-030-99918-6_26

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