Medicine Matters oncology

Features: Patients present with physical symptoms ranging from worsening frontal headaches (particularly when bending forward), to excessive fatigue, weakness, dizziness, nausea, and vomiting. 

Management: Hypophysitis is diagnosed by biochemical evidence of anterior pituitary hormone deficiency and by MRI scan of the brain with pituitary slices to assess for inflammation of the pituitary gland. Although there is a paucity of research on the management of immune-related hypophysitis, it has been argued that intravenous glucosteroids such as methylprednisolone may reduce swelling of the pituitary gland, thus helping to improve symptoms [7].  Adrenocorticotropic hormone (ACTH) and/or TSH deficiency are the most common pituitary hormone abnormalities that have been described in patients with hypophysitis, and often require lifelong replacement of steroids for adrenal insufficiency. Although recovery of secondary hypothyroidism can occur, it has not been well studied.