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 |