Evaluation and follow-up of patients diagnosed with hypophysitis: A cohort study

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dc.authorid0000-0001-7984-6284
dc.contributor.authorHacıoğlu, Ayşa
dc.contributor.authorKaraca, Züleyha
dc.contributor.authorUysal, Serhat
dc.contributor.authorÖzkaya, Hande Mefkure
dc.contributor.authorKadıoğlu, Pınar
dc.contributor.authorSoyluk Selçukbiricik, Özlem
dc.contributor.authorGül, Nurdan
dc.contributor.authorYarman, Sema
dc.contributor.authorKöksalan, Damla
dc.contributor.authorSelek, Alev
dc.contributor.authorCantürk, Zeynep
dc.contributor.authorÇetinarslan, Berrin
dc.contributor.authorÇorapçıoğlu, Demet
dc.contributor.authorŞahin, Mustafa
dc.contributor.authorŞah Ünal, Fatma Tuğçe
dc.contributor.authorBabayeva, Afruz
dc.contributor.authorAktürk, Müjde
dc.contributor.authorÇiftçi, Sema
dc.contributor.authorPişkinpaşa, Hamide
dc.contributor.authorDökmetaş, Hatice Sebile
dc.contributor.authorDökmetaş, Meriç
dc.contributor.authorŞahin, Onur
dc.contributor.authorEraydın, Ayten
dc.contributor.authorFenkçi, Semin
dc.contributor.authorÖztürk, Sadettin
dc.contributor.authorAkarsu, Ersin
dc.contributor.authorOmma, Tülay
dc.contributor.authorErkan, Buruç
dc.contributor.authorBurhan, Şebnem
dc.contributor.authorPehlivan Koroğlu, Esma
dc.contributor.authorSaygılı, Füsun
dc.contributor.authorKılıç Kan, Elif
dc.contributor.authorAtmaca, Ayşegül
dc.contributor.authorElbüken, Gülşah
dc.contributor.authorAlphan Uç, Ziynet
dc.contributor.authorGörar, Süheyla
dc.contributor.authorHekimsoy, Zeliha
dc.contributor.authorPekkolay, Zafer
dc.contributor.authorBostan, Hayri
dc.contributor.authorBayram, Fahri
dc.contributor.authorYorulmaz, Göknur
dc.contributor.authorŞener, Selçuk Yusuf
dc.contributor.authorTuran, Kübra
dc.contributor.authorÇelik, Özlem
dc.contributor.authorDoğruel, Hakan
dc.contributor.authorErtörer, Eda
dc.contributor.authorTurhan İyidir, Özlem
dc.contributor.authorTopaloğlu, Ömercan
dc.contributor.authorCansu, Güven Barış
dc.contributor.authorÜnlühizarcı, Kürşad
dc.contributor.authorKeleştimur, Fahrettin
dc.date.accessioned2024-11-08T06:58:28Z
dc.date.available2024-11-08T06:58:28Z
dc.date.issued2024
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, İç Hastalıkları Ana Bilim Dalı
dc.description.abstractObjective: Primary hypophysitis might be challenging to diagnose, and there is a lack of evidence regarding optimal treatment strategies due to rarity of the disease. We aim to investigate the clinical features and compare the outcomes of different management strategies of primary hypophysitis in a large group of patients recruited on a nationwide basis. Design: A retrospective observational study. Methods: The demographic, clinical, and radiologic features and follow-up data were collected in study protocol templates and analyzed. Results: One hundred and thirteen patients (78.8% female, median age: 36 years) were included. Lymphocytic (46.7%) and granulomatous hypophysitis (35.6%) were the prevailing subtypes out of 45 patients diagnosed after pathologic investigations. Headache (75.8%) was the most common symptom, and central hypogonadism (49.5%) was the most common hormone insufficiency. Of the patients, 52.2% were clinically observed without interventions, 18.6% were started on glucocorticoid therapy, and 29.2% underwent surgery at presentation. Headache, suprasellar extension, and chiasmal compression were more common among glucocorticoid-treated patients than who were observed. Cox regression analysis revealed higher hormonal and radiologic improvement rates in the glucocorticoid-treated group than observation group (hazard ratio, 4.60; 95% CI, 1.62-12.84 and HR, 3.1; 95% CI, 1.40-6.68, respectively). The main indication for surgery was the inability to exclude a pituitary adenoma in the presence of compression symptoms, with a recurrence rate of 9%. Conclusion: The rate of spontaneous improvement might justify observation in mild cases. Glucocorticoids proved superior to observation in terms of hormonal and radiologic improvements. Surgery may not be curative and might be considered in indeterminate, treatment-resistant, or severe cases.
dc.identifier.citationHacıoğlu, A., Karaca, Z., Uysal, S., Özkaya, H. M., Kadıoğlu, P., Soyluk Selçukbiricik, Ö. ... Keleştimur, F. (2024). Evaluation and follow-up of patients diagnosed with hypophysitis: A cohort study. European Journal of Endocrinology, 191(3), 312-322. http://dx.doi.org/10.1093/ejendo/lvae101
dc.identifier.doi10.1093/ejendo/lvae101
dc.identifier.endpage322
dc.identifier.issn0804-4643
dc.identifier.issn1479-683X
dc.identifier.issue3
dc.identifier.pmid39186535
dc.identifier.scopus2-s2.0-85203473895
dc.identifier.scopusqualityQ1
dc.identifier.startpage312
dc.identifier.urihttp://dx.doi.org/10.1093/ejendo/lvae101
dc.identifier.urihttps://hdl.handle.net/20.500.12511/12877
dc.identifier.volume191
dc.identifier.wos001307744600001en_US
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorDökmetaş, Meriç
dc.institutionauthorŞahin, Onur
dc.language.isoen
dc.relation.ispartofEuropean Journal of Endocrinologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectAdrenal Insufficiency
dc.subjectGlucocorticoids
dc.subjectHypogonadism
dc.subjectHypophysitis
dc.subjectObservation
dc.titleEvaluation and follow-up of patients diagnosed with hypophysitis: A cohort study
dc.typeArticle

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