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Table 1 Brief summary of cases using azathioprine or rituximab in autoimmune hypophysitis

From: Recurrent autoimmune hypophysitis treated with rituximab: a case report

Refs. Case characteristics Treatment Histology Outcome
Xu et al. [14] 54-year-old female with uveitis, scleritis, and diabetes insipidus Infliximab and rituximab CD20-positive B lymphocytes as the dominant cell type Remission (follow-up 18 months)
Schreckinger et al. [13] 41-year-old female with visual loss in the left eye and sellar mass Relapse at high-dose methylprednisolone. Changed to rituximab CD20-positive B lymphocytes as the dominant cell type Stable clinical and radiological improvement
De Bellis et al. [20] 36-year-old male with primary immune thrombocytopenia (ITP) and hypogonadotropic hypogonadism Rituximab Clinical diagnosis of autoimmune hypophysitis
No histopathology
Complete remission of ITP and autoimmune hypophysitis
Lecube et al. [19] 53-year-old male with frontal headache, diplopia, and diabetes insipidus Relapse at prednisolone. Changed to azathioprine Mixed B and T lymphocytes Complete resolution
Curto et al. [22] 38-year-old male with diplopia, blurred vision, and headaches Relapse at high-dose methylprednisolone. Changed to azathioprine Typical features of autoimmune hypophysitis Decrease in pituitary mass
Lu et al. [23] 22-year-old female with headache, diplopia, left eye ptosis, and lactation Relapse after transsphenoidal surgery. High-dose methylprednisolone and azathioprine Lymphocytic, histiocytic, and neutrophil infiltration consistent with AH Uneventful pregnancy and delivery
Long-term remission
Wang et al. [24] 70-year-old female with diabetes insipidus and adenopituitary function deficiency Relapse after glucocorticoid treatment
High-dose methylprednisolone and azathioprine
Clinical diagnosis of autoimmune hypothalamitis
No histopathology
Remission on treatment
Yang et al. [25] 1) 22-year-old female with headache and diplopia
2) 70-year-old female with diabetes insipidus and dry mouth
3) 32-year-old female with diabetes insipidus, menstrual disorder, headache, and dizziness
Recurrence after surgery and prednisolone respectively.
Changed to high-dose methylprednisolone followed by prednisolone and azathioprine for all cases
Lymphocytic infiltration in pituitary tissue in case 1
No other histopathology
Complete resolution on MRI with endocrine recovery in case 1 and 3 and permanent hypopituitarism in case 2
Katsivali et al. [26] 48-year-old female with headache, muscle weakness, and occlusion of both internal carotid arteries Relapse when prednisolone tapering
Due to adverse effects, treatment was changed to azathioprine
Clinically suspected AH
No histopathology
Complete resolution and restored pituitary function
Curto et al. [27] 38-year-old male with diplopia, ophthalmoplegia, and headache Initial response on high-dose methylprednisolone. Changed to azathioprine Lymphocytes with CD20-positive B cells and CD3-positive T cells No response to treatment