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      Hypophysitis: Evaluation and Management

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      Author(s):
      Publication date (Electronic):
      Journal: Clinical Diabetes and Endocrinology
      Publisher: BioMed Central
      Keywords: Hypophysitis, Hypopituitarism, Diabetes insipidus

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          Abstract

          Hypophysitis is the acute or chronic inflammation of the pituitary gland. The spectrum of hypophysitis has expanded in recent years with the addition of two histologic subtypes and recognition as a complication of treatment with immune checkpoint inhibitors. Despite the increased number of published cases, the pathogenesis of hypophysitis is poorly understood, and treatment strategies are diverse and controversial. The diagnosis of hypophysitis generally requires histopathologic confirmation. The presentation and clinical course of hypophysitis varies. Hypophysitis can resolve spontaneously, relapse may occur, and some cases can be refractory to treatment.

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          Specificity and affinity of human Fcgamma receptors and their polymorphic variants for human IgG subclasses.

          Pierre Bruhns, Bruno Iannascoli, Patrick England … (2009)
          Distinct genes encode 6 human receptors for IgG (hFcgammaRs), 3 of which have 2 or 3 polymorphic variants. The specificity and affinity of individual hFcgammaRs for the 4 human IgG subclasses is unknown. This information is critical for antibody-based immunotherapy which has been increasingly used in the clinics. We investigated the binding of polyclonal and monoclonal IgG1, IgG2, IgG3, and IgG4 to FcgammaRI; FcgammaRIIA, IIB, and IIC; FcgammaRIIIA and IIIB; and all known polymorphic variants. Wild-type and low-fucosylated IgG1 anti-CD20 and anti-RhD mAbs were also examined. We found that (1) IgG1 and IgG3 bind to all hFcgammaRs; (2) IgG2 bind not only to FcgammaRIIA(H131), but also, with a lower affinity, to FcgammaRIIA(R131) and FcgammaRIIIA(V158); (3) IgG4 bind to FcgammaRI, FcgammaRIIA, IIB and IIC and FcgammaRIIIA(V158); and (4) the inhibitory receptor FcgammaRIIB has a lower affinity for IgG1, IgG2, and IgG3 than all other hFcgammaRs. We also identified parameters that determine the specificity and affinity of hFcgammaRs for IgG subclasses. These results document how hFcgammaR specificity and affinity may account for the biological activities of antibodies. They therefore highlight the role of specific hFcgammaRs in the therapeutic and pathogenic effects of antibodies in disease.
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            IgG4-Related Disease: Clinical and Laboratory Features in One Hundred Twenty-Five Patients.

            Zachary Wallace, Vikram Deshpande, Hamid Mattoo … (2015)
            IgG4-related disease (IgG4-RD) is an immune-mediated fibroinflammatory condition that can affect nearly any organ. Prior studies have focused on individual cases of IgG4-RD or small case series. This study was undertaken to report detailed clinical and laboratory findings in a larger group of patients with IgG4-RD whose diagnosis was established by strict clinicopathologic correlation.
            Article 0 comments Cited 199 times – based on 0 reviews     Review now
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              Autoimmune hypophysitis.

              Craig Newschaffer, Alessandro Olivi, Karina P Bürger … (2005)
              Autoimmune (lymphocytic) hypophysitis is a rare disease that should be considered in the differential diagnosis of any nonsecreting pituitary mass, especially when occurring during pregnancy or postpartum. We have analyzed 370 articles published from January 1962 to October 2004 and identified a total of 379 patients with primary lymphocytic hypophysitis. The present review synthesizes the clinical and research data reported in this body of scientific literature.
              Article 0 comments Cited 157 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Alexander Faje:
                ORCID: http://orcid.org/0000-0002-4092-5409
                (617) 726-7948 , afaje@partners.org
                Journal
                Journal ID (nlm-ta): Clin Diabetes Endocrinol
                Journal ID (iso-abbrev): Clin Diabetes Endocrinol
                Title: Clinical Diabetes and Endocrinology
                Publisher: BioMed Central (London )
                ISSN (Electronic): 2055-8260
                Publication date (Electronic): 6 September 2016
                Publication date PMC-release: 6 September 2016
                Publication date Collection: 2016
                Volume: 2
                Electronic Location Identifier: 15
                Affiliations
                GRID grid.32224.35, ISNI 0000000403869924, Neuroendocrine Unit, , Massachusetts General Hospital and Harvard Medical School, ; 55 Fruit Street, Boston, MA 02114 USA
                Author information
                http://orcid.org/0000-0002-4092-5409
                Article
                Publisher ID: 34
                DOI: 10.1186/s40842-016-0034-8
                PMC ID: 5471685
                PubMed ID: 28702249
                SO-VID: 27f56665-4b02-492f-aaff-8bde439b7f5f
                Copyright © © The Author(s). 2016
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 1 July 2016
                Date accepted : 26 August 2016
                Categories
                Subject: Review Article
                Custom metadata
                issue-copyright-statement © The Author(s) 2016

                Keywords: hypophysitis,hypopituitarism,diabetes insipidus
                Data availability:
                Keywords: hypophysitis, hypopituitarism, diabetes insipidus

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