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Article: Primary hypophysitis: A single-center experience in 16 cases

TitlePrimary hypophysitis: A single-center experience in 16 cases
Authors
Issue Date2004
PublisherAmerican Association of Neurological Surgeons. The Journal's web site is located at http://www.thejns-net.org
Citation
Journal Of Neurosurgery, 2004, v. 101 n. 2, p. 262-271 How to Cite?
AbstractObject. The authors review their experience in the treatment of 16 patients with primary hypophysitis. Methods. A retrospective study was undertaken to review cases of primary hypophysitis. The mean age of the patients was 47 years and there was an equal distribution of sexes. Recent pregnancy and underlying autoimmunity were noted in 50% of the patients. Two patients had undergone previous transsphenoidal operations at other centers, one for prolactinoma and another for hypophysitis. Headache, anterior pituitary deficiency, and suprasellar mass lesions were the most common presenting features. The initial presumptive diagnosis was pituitary adenoma in six patients (37.5%) and inflammatory hypophysitis in 10 (62.5%). Five patients received initial medical therapy for hypophysitis; although three (60%) responded satisfactorily, two (40%) did not and later underwent surgery. Altogether 13 patients (81.2%) underwent transsphenoidal surgery. The histological diagnoses were lymphocytic hypophysitis in 10 (76.9%) and granulomatous hypophysitis in three (23.1%) of the surgically treated patients. A coexistent Rathke cleft cyst was noted in one patient. There was no death in this series. One patient experienced postoperative cerebrospinal fluid leakage and meningitis. One patient had bilateral internal carotid artery occlusion secondary to inflammatory involvement of the cavernous sinuses and arteritis. This patient recovered and is capable of independent functional activities. Conclusions. All surgical patients experienced improvement in their headache and/or visual field defects and none had visual deterioration. None of the patients experienced any improvement in endocrine function and all required long-term hormone replacement. Transsphenoidal surgery was a safe and effective treatment especially for visual and pressure symptoms. A postoperative recurrence developed in two patients (15.4%) and the treatment modalities included steroid therapy, repeated surgery, and radiosurgery.
Persistent Identifierhttp://hdl.handle.net/10722/172904
ISSN
2015 Impact Factor: 3.443
2015 SCImago Journal Rankings: 1.673
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLeung, GKKen_US
dc.contributor.authorLopes, MBSen_US
dc.contributor.authorThorner, MOen_US
dc.contributor.authorVance, MLen_US
dc.contributor.authorLaws Jr, ERen_US
dc.date.accessioned2012-10-30T06:25:43Z-
dc.date.available2012-10-30T06:25:43Z-
dc.date.issued2004en_US
dc.identifier.citationJournal Of Neurosurgery, 2004, v. 101 n. 2, p. 262-271en_US
dc.identifier.issn0022-3085en_US
dc.identifier.urihttp://hdl.handle.net/10722/172904-
dc.description.abstractObject. The authors review their experience in the treatment of 16 patients with primary hypophysitis. Methods. A retrospective study was undertaken to review cases of primary hypophysitis. The mean age of the patients was 47 years and there was an equal distribution of sexes. Recent pregnancy and underlying autoimmunity were noted in 50% of the patients. Two patients had undergone previous transsphenoidal operations at other centers, one for prolactinoma and another for hypophysitis. Headache, anterior pituitary deficiency, and suprasellar mass lesions were the most common presenting features. The initial presumptive diagnosis was pituitary adenoma in six patients (37.5%) and inflammatory hypophysitis in 10 (62.5%). Five patients received initial medical therapy for hypophysitis; although three (60%) responded satisfactorily, two (40%) did not and later underwent surgery. Altogether 13 patients (81.2%) underwent transsphenoidal surgery. The histological diagnoses were lymphocytic hypophysitis in 10 (76.9%) and granulomatous hypophysitis in three (23.1%) of the surgically treated patients. A coexistent Rathke cleft cyst was noted in one patient. There was no death in this series. One patient experienced postoperative cerebrospinal fluid leakage and meningitis. One patient had bilateral internal carotid artery occlusion secondary to inflammatory involvement of the cavernous sinuses and arteritis. This patient recovered and is capable of independent functional activities. Conclusions. All surgical patients experienced improvement in their headache and/or visual field defects and none had visual deterioration. None of the patients experienced any improvement in endocrine function and all required long-term hormone replacement. Transsphenoidal surgery was a safe and effective treatment especially for visual and pressure symptoms. A postoperative recurrence developed in two patients (15.4%) and the treatment modalities included steroid therapy, repeated surgery, and radiosurgery.en_US
dc.languageengen_US
dc.publisherAmerican Association of Neurological Surgeons. The Journal's web site is located at http://www.thejns-net.orgen_US
dc.relation.ispartofJournal of Neurosurgeryen_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshFemaleen_US
dc.subject.meshGiant Cell Arteritis - Complicationsen_US
dc.subject.meshGranulomatous Disease, Chronic - Complicationsen_US
dc.subject.meshGraves Disease - Complicationsen_US
dc.subject.meshHumansen_US
dc.subject.meshHydrocortisone - Blooden_US
dc.subject.meshHypothyroidism - Complicationsen_US
dc.subject.meshInflammation - Pathology - Surgeryen_US
dc.subject.meshMagnetic Resonance Imagingen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPituitary Diseases - Diagnosis - Surgery - Therapyen_US
dc.subject.meshPituitary Gland - Metabolism - Pathology - Surgeryen_US
dc.subject.meshPituitary Neoplasms - Complicationsen_US
dc.subject.meshPostoperative Complicationsen_US
dc.subject.meshProlactinoma - Complicationsen_US
dc.subject.meshRadiosurgeryen_US
dc.subject.meshRetrospective Studiesen_US
dc.subject.meshSteroids - Therapeutic Useen_US
dc.titlePrimary hypophysitis: A single-center experience in 16 casesen_US
dc.typeArticleen_US
dc.identifier.emailLeung, GKK: gilberto@hkucc.hku.hken_US
dc.identifier.authorityLeung, GKK=rp00522en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.3171/jns.2004.101.2.0262-
dc.identifier.pmid15309917-
dc.identifier.scopuseid_2-s2.0-3242806709en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-3242806709&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume101en_US
dc.identifier.issue2en_US
dc.identifier.spage262en_US
dc.identifier.epage271en_US
dc.identifier.isiWOS:000223000600014-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridLeung, GKK=35965118200en_US
dc.identifier.scopusauthoridLopes, MBS=35479962200en_US
dc.identifier.scopusauthoridThorner, MO=7102935307en_US
dc.identifier.scopusauthoridVance, ML=7102823154en_US
dc.identifier.scopusauthoridLaws Jr, ER=25950075000en_US

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