Hypophysitis Research Center

Diagnosis & Treatment

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How Hypophysitis is Diagnosed +

The diagnosis of Autoimmune Hypophysitis (AH) is still mainly a diagnosis of exclusion. Patients often undergo surgery because they are suspected of having a pituitary adenoma. The histological exam, however, shows autoimmune hypophysitis instead. The accurate diagnosis of AH has been greatly facilitated by the introduction of magnetic resonance imaging (MRI). However, it is safe to say that no other pituitary mass lesion so consistently challenges a correct pre-operative diagnosis as AH. Of clear benefit would be the development of a screening test based on the autoimmune pathogenesis of this disease. In most of the patients reported in the literature the diagnosis was based on histology, obtained either after surgery (223) or at autopsy (26), see table below.

We believe, however, that autoimmune hypophysitis is not a surgical disease, and surgery could be avoided if the diagnosis of AH could be established without histology. Surgery should be reserved only for those cases where the pituitary mass seriously endangers the patient's vision.

How Diagnosis Was MadeNo. of Cases
Based on histology 249
Surgical pathology223
Autopsy 26
Based on clinical and radiological criteria76
Based on clinical criteria only7

Which physician can help you? +

After the diagnosis
Because of the only recent improvement in understanding of autoimmune hypophysitis, a small number of cases have been identified before a surgery approach. For this reason it is difficult to suggest a flow-chart of therapy, prognosis and follow-up.

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  • The Primary Care Provider
  • The Endocrinologist
  • The Ophthalmologist
  • The Radiologist

Therapy, Prognosis, & Follow-up +

After the diagnosis
Because of the only recent improvement in understanding of autoimmune hypophysitis, a small number of cases have been identified before a surgery approach. For this reason it is difficult to suggest a flow-chart of therapy, prognosis and follow-up.

Click the two links below to read more about the topics:

  • Therapy
  • Prognosis
  • Follow-Up