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  1 / 28 MEDLINE  
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[PMID]:29187509
[Au] Autor:Scott ES; Long GV; Guminski A; Clifton-Bligh RJ; Menzies AM; Tsang VH
[Ad] Endereço:Department of EndocrinologyRoyal North Shore Hospital, Sydney, Australia.
[Ti] Título:The spectrum, incidence, kinetics and management of endocrinopathies with immune checkpoint inhibitors for metastatic melanoma.
[So] Source:Eur J Endocrinol;178(2):175-182, 2018 Feb.
[Is] ISSN:1479-683X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Endocrine immune-related adverse events (endocrinopathies) are increasingly prevalent with the use of immune checkpoint inhibitors for the treatment of metastatic melanoma and other malignancies. There are no evidence-based guidelines for the screening or management of such patients. To describe the spectrum, incidence, kinetics and management of endocrinopathies with immune checkpoint inhibitors. DESIGN: A prospective study conducted at Melanoma Institute Australia between April 2014 and October 2015. METHODS: A total of 177 patients were treated with (a) ipilimumab ( = 15), (b) anti-PD-1 (nivolumab, pembrolizumab) ( = 103) or (c) combination ipilimumab and anti-PD-1 ( = 59) and were screened and managed for the subsequent endocrinopathies. The main outcome measures were the incidence and kinetics of endocrinopathy by immunotherapy drug class. RESULTS: Thirty-one patients (18%) developed an endocrine immune-related adverse event (thyroid dysfunction: 14%, hypophysitis: 6% and autoimmune diabetes: 0.6%). Combination immunotherapy was more likely to result in a single or multiple endocrinopathy compared to anti-PD-1 monotherapy (27% vs 9% and 7% vs 0% respectively, < 0.01). Endocrinopathies occurred after a median of 8 weeks from treatment commencement (range: 12-225 days), with combination immunotherapy resulting in significantly earlier onset compared to ipilimumab (median: 30 vs 76 days, = 0.046). The majority of endocrinopathies were identified in asymptomatic patients with hormonal screening. There were no baseline predictors for endocrinopathy. CONCLUSIONS: Combination immunotherapy has a greater risk of development of endocrinopathy compared to anti-PD-1 monotherapy. Regular biochemical profiling of patients, particularly within the first twelve weeks, results in early detection of endocrinopathy to minimise morbidity.
[Mh] Termos MeSH primário: Doenças do Sistema Endócrino/epidemiologia
Doenças do Sistema Endócrino/etiologia
Imunoterapia/efeitos adversos
Melanoma/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Anticorpos Monoclonais/efeitos adversos
Anticorpos Monoclonais/uso terapêutico
Anticorpos Monoclonais Humanizados/efeitos adversos
Austrália
Doenças Autoimunes/etiologia
Diabetes Mellitus/epidemiologia
Diabetes Mellitus/etiologia
Diabetes Mellitus/imunologia
Quimioterapia Combinada/efeitos adversos
Doenças do Sistema Endócrino/fisiopatologia
Feminino
Seres Humanos
Hipofisite/epidemiologia
Hipofisite/etiologia
Ipilimumab/efeitos adversos
Masculino
Meia-Idade
Receptor de Morte Celular Programada 1/imunologia
Estudos Prospectivos
Doenças da Glândula Tireoide/epidemiologia
Doenças da Glândula Tireoide/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Monoclonal); 0 (Antibodies, Monoclonal, Humanized); 0 (Ipilimumab); 0 (PDCD1 protein, human); 0 (Programmed Cell Death 1 Receptor); 31YO63LBSN (nivolumab); DPT0O3T46P (pembrolizumab)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180110
[Lr] Data última revisão:
180110
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE
[do] DOI:10.1530/EJE-17-0810


  2 / 28 MEDLINE  
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[PMID]:28871578
[Au] Autor:Seki T; Yasuda A; Oki M; Kitajima N; Takagi A; Nakajima N; Miyajima A; Fukagawa M
[Ad] Endereço:Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, 143 Shimokasuya, Iseharashi, Kanagawa 259-1193, Japan. tsekimdpdd@tokai-u.jp.
[Ti] Título:Secondary Adrenal Insufficiency Following Nivolumab Therapy in a Patient with Metastatic Renal Cell Carcinoma.
[So] Source:Tokai J Exp Clin Med;42(3):115-120, 2017 Sep 20.
[Is] ISSN:2185-2243
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:Currently, nivolumab (an anti-programmed cell death-1 receptor monoclonal antibody) is available for many types of advanced cancers in Japan. However, there have been few detailed case reports about endocrine-related adverse events of this therapy. Here, we report a patient with metastatic renal cell carcinoma who presented with secondary adrenal insufficiency following nivolumab therapy. Endocrinological assessment by rapid adrenocorticotropic hormone (ACTH) and corticotropin-releasing hormone (CRH) tests revealed that the patient's disorder was a secondary adrenal insufficiency due to pituitary dysfunction. Moreover, the results of the thyrotropin-releasing hormone (TRH), luteinizing hormone-releasing hormone (LH-RH) and growth hormone-releasing peptide-2 (GHRP-2) tests showed that only the ACTH function was destroyed (isolated ACTH deficiency). The magnetic resonance imaging (MRI) findings of hypophysitis, which is the major cause of isolated ACTH deficiency, usually demonstrate enlargement of the pituitary gland. However, the MRI findings of our case showed no abnormalities of the pituitary gland and stalk. Therefore, not only oncologists, but also other specialists, including doctors in emergency units, should have knowledge of this specific feature. Our clinical observation could be useful to avoid a delay in diagnosis and to treat life-threatening adverse effects of nivolumab therapy, such as secondary adrenal insufficiency.
[Mh] Termos MeSH primário: Insuficiência Adrenal/induzido quimicamente
Anticorpos Monoclonais/efeitos adversos
Antineoplásicos/efeitos adversos
Carcinoma de Células Renais/tratamento farmacológico
Neoplasias Renais/tratamento farmacológico
[Mh] Termos MeSH secundário: Insuficiência Adrenal/diagnóstico
Hormônio Adrenocorticotrópico/sangue
Idoso
Anticorpos Monoclonais/administração & dosagem
Antineoplásicos/administração & dosagem
Biomarcadores/sangue
Carcinoma de Células Renais/secundário
Hormônio Liberador da Corticotropina/sangue
Feminino
Seres Humanos
Hiponatremia/induzido quimicamente
Hipofisite/complicações
Hipofisite/diagnóstico por imagem
Infusões Intravenosas
Neoplasias Renais/secundário
Imagem por Ressonância Magnética
Doenças da Hipófise/complicações
Doenças da Hipófise/diagnóstico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Monoclonal); 0 (Antineoplastic Agents); 0 (Biomarkers); 31YO63LBSN (nivolumab); 9002-60-2 (Adrenocorticotropic Hormone); 9015-71-8 (Corticotropin-Releasing Hormone)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170906
[St] Status:MEDLINE


  3 / 28 MEDLINE  
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[PMID]:28693060
[Au] Autor:Wei Q; Zang L; Li YJ; Gu WJ; Jin N; Guo QH; Du J; Ba JM; Lyu ZH; Lu JM; Dou JT; Mu YM; Yang GQ
[Ad] Endereço:Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China.
[Ti] Título:[An analysis of four cases of misdiagnosed primary lymphocytic hypophysitis].
[So] Source:Zhonghua Nei Ke Za Zhi;56(7):512-515, 2017 Jul 01.
[Is] ISSN:0578-1426
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To improve the differential diagnosis of sellar region mass, 4 cases with sellar mass and misdiagnosed as lymphocytic hypophysitis (LYH) were reviewed retrospectively.The 4 patients (2 male and 2 female) aged 20-60 years old were all presented with symptoms of headache, polydipsia and polyuria.Biochemical studies confirmed the diagnoses of central diabetes insipidus and hypopituitarism.Head MRI scans showed LYH like image for all the cases, and, thus, high dose methylprednisolone pulse therapy (HDMPT) was applied to the patients.Their symptoms deteriorated and the sellar mass enlarged after a short period of partial improvement.Operations were performed in all the patients.Histology study showed craniopharyngioma with abscess, primary abscess, secondary hypophysitis caused by Wegener's granulomatosis, and germinoma with secondary hypophysitis, respectively.In conclusion, surgery or biopsy is necessary for those who presented with sellar region mass and was suspected to be with LYH, but with poor response or even worse after HDMPT.
[Mh] Termos MeSH primário: Diabetes Insípido/complicações
Germinoma/complicações
Hipofisite/complicações
Hipopituitarismo/etiologia
Imagem por Ressonância Magnética
Doenças da Hipófise/etiologia
[Mh] Termos MeSH secundário: Abscesso
Adulto
Biópsia
Feminino
Germinoma/patologia
Cefaleia
Seres Humanos
Hipofisite/diagnóstico
Hipopituitarismo/diagnóstico por imagem
Hipopituitarismo/patologia
Masculino
Meia-Idade
Doenças da Hipófise/diagnóstico por imagem
Doenças da Hipófise/patologia
Estudos Retrospectivos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170711
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0578-1426.2017.07.008


  4 / 28 MEDLINE  
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[PMID]:28603206
[Au] Autor:Iwama S; Arima H
[Ad] Endereço:Research Center of Health, Physical Fitness and Sports, Nagoya University.
[Ti] Título:Clinical practice and mechanism of endocrinological adverse events associated with immune checkpoint inhibitors.
[So] Source:Nihon Rinsho Meneki Gakkai Kaishi;40(2):90-94, 2017.
[Is] ISSN:1349-7413
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:Immune checkpoint inhibitors, used for cancer immunotherapy, show anti-tumor effects through T cell activations. Monoclonal antibodies against cytotoxic T lymphocyte antigen-4 (CTLA-4), programmed cell death (PD)-1, or PD-ligand 1 which is a ligand of PD-1 have been shown to be effective in the treatments of advanced cancers including malignant melanoma, non-small cell lung cancer, and renal cell carcinoma. However, these drugs also have immune-related adverse events (irAEs). The irAEs, which have unique characteristics different from those seen in conventional cytotoxic anti-tumor medicines, are observed in the several tissues such as skin, gastrointestinal tract, liver, lung, muscle, nerve and endocrine systems. To safely use immune checkpoint inhibitors, it is quite important to understand the characteristics of irAEs and to manage them in clinical practice. In this review, we focus on clinical characteristics and pathogenesis of adverse events in the pituitary gland.
[Mh] Termos MeSH primário: Anticorpos Monoclonais/efeitos adversos
Doenças da Hipófise/etiologia
[Mh] Termos MeSH secundário: Anticorpos Monoclonais/uso terapêutico
Antígeno CTLA-4/imunologia
Seres Humanos
Hipofisite/etiologia
Hipofisite/terapia
Hipopituitarismo/epidemiologia
Hipopituitarismo/etiologia
Ipilimumab
Neoplasias/tratamento farmacológico
Doenças da Hipófise/terapia
Receptor de Morte Celular Programada 1/imunologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antibodies, Monoclonal); 0 (CTLA-4 Antigen); 0 (Ipilimumab); 0 (PDCD1 protein, human); 0 (Programmed Cell Death 1 Receptor); 31YO63LBSN (nivolumab)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170613
[St] Status:MEDLINE
[do] DOI:10.2177/jsci.40.90


  5 / 28 MEDLINE  
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[PMID]:28583458
[Au] Autor:Lin W; Gao L; Guo X; Wang W; Xing B
[Ad] Endereço:Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, People's Republic of China; Peking Union Medical College, Beijing, People's Republic of China.
[Ti] Título:Xanthomatous Hypophysitis Presenting with Diabetes Insipidus Completely Cured Through Transsphenoidal Surgery: Case Report and Literature Review.
[So] Source:World Neurosurg;104:1051.e7-1051.e13, 2017 Aug.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Xanthomatous hypophysitis (XH) is extremely rare. Only 27 cases have been reported in the literature. No XH patient presenting with diabetes insipidus (DI) has been completely cured through surgery. Here, we describe the first XH case of a DI patient whose pituitary function was normalized postoperatively, without hormone replacement therapy. CASE DESCRIPTION: A 41-year-old woman suffered from polydipsia, DI, headache, and breast discharge. Laboratory investigation revealed hyperprolactinemia. Pituitary magnetic resonance imaging showed a 2.0-cm × 1.4-cm × 1.6-cm lesion that demonstrated heterogeneous intensity on T1-weighted imaging and peripheral ring enhancement following contrast; the lesion was totally removed through transsphenoidal surgery. Histopathologic and immunohistochemical examinations confirmed the diagnosis of XH. At the 4- and 15-month follow-up visits, all pituitary-related hormones were normal, and the patient was not taking medication. A repeat pituitary magnetic resonance imaging showed no evidence of recurrence. CONCLUSIONS: To the best of our knowledge, this case is the first documented occurrence of XH with DI completely cured through surgery. If XH is suspected, total surgical resection of the lesion is recommended and normal pituitary tissue should be carefully protected intraoperatively.
[Mh] Termos MeSH primário: Diabetes Insípido/cirurgia
Hiperprolactinemia/cirurgia
Hipofisite/cirurgia
Xantomatose/cirurgia
[Mh] Termos MeSH secundário: Adulto
Diabetes Insípido/etiologia
Feminino
Seres Humanos
Hiperprolactinemia/etiologia
Hipofisite/complicações
Hipofisite/diagnóstico por imagem
Imagem por Ressonância Magnética
Neuroendoscopia
Xantomatose/complicações
Xantomatose/diagnóstico por imagem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170607
[St] Status:MEDLINE


  6 / 28 MEDLINE  
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[PMID]:28359784
[Au] Autor:Ascierto PA; Del Vecchio M; Robert C; Mackiewicz A; Chiarion-Sileni V; Arance A; Lebbé C; Bastholt L; Hamid O; Rutkowski P; McNeil C; Garbe C; Loquai C; Dreno B; Thomas L; Grob JJ; Liszkay G; Nyakas M; Gutzmer R; Pikiel J; Grange F; Hoeller C; Ferraresi V; Smylie M; Schadendorf D; Mortier L; Svane IM; Hennicken D; Qureshi A; Maio M
[Ad] Endereço:Istituto Nazionale Tumori Fondazione Pascale, Naples, Italy. Electronic address: paolo.ascierto@gmail.com.
[Ti] Título:Ipilimumab 10 mg/kg versus ipilimumab 3 mg/kg in patients with unresectable or metastatic melanoma: a randomised, double-blind, multicentre, phase 3 trial.
[So] Source:Lancet Oncol;18(5):611-622, 2017 May.
[Is] ISSN:1474-5488
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: A phase 2 trial suggested increased overall survival and increased incidence of treatment-related grade 3-4 adverse events with ipilimumab 10 mg/kg compared with ipilimumab 3 mg/kg in patients with advanced melanoma. We report a phase 3 trial comparing the benefit-risk profile of ipilimumab 10 mg/kg versus 3 mg/kg. METHODS: This randomised, double-blind, multicentre, phase 3 trial was done in 87 centres in 21 countries worldwide. Patients with untreated or previously treated unresectable stage III or IV melanoma, without previous treatment with BRAF inhibitors or immune checkpoint inhibitors, were randomly assigned (1:1) with an interactive voice response system by the permuted block method using block size 4 to ipilimumab 10 mg/kg or 3 mg/kg, administered by intravenous infusion for 90 min every 3 weeks for four doses. Patients were stratified by metastasis stage, previous treatment for metastatic melanoma, and Eastern Cooperative Oncology Group performance status. The patients, investigators, and site staff were masked to treatment assignment. The primary endpoint was overall survival in the intention-to-treat population and safety was assessed in all patients who received at least one dose of study treatment. This study is completed and was registered with ClinicalTrials.gov, number NCT01515189. FINDINGS: Between Feb 29, and July 9, 2012, 727 patients were enrolled and randomly assigned to ipilimumab 10 mg/kg (365 patients; 364 treated) or ipilimumab 3 mg/kg (362 patients; all treated). Median follow-up was 14·5 months (IQR 4·6-42·3) for the ipilimumab 10 mg/kg group and 11·2 months (4·9-29·4) for the ipilimumab 3 mg/kg group. Median overall survival was 15·7 months (95% CI 11·6-17·8) for ipilimumab 10 mg/kg compared with 11·5 months (9·9-13·3) for ipilimumab 3 mg/kg (hazard ratio 0·84, 95% CI 0·70-0·99; p=0·04). The most common grade 3-4 treatment-related adverse events were diarrhoea (37 [10%] of 364 patients in the 10 mg/kg group vs 21 [6%] of 362 patients in the 3 mg/kg group), colitis (19 [5%] vs nine [2%]), increased alanine aminotransferase (12 [3%] vs two [1%]), and hypophysitis (ten [3%] vs seven [2%]). Treatment-related serious adverse events were reported in 133 (37%) patients in the 10 mg/kg group and 66 (18%) patients in the 3 mg/kg group; four (1%) versus two (<1%) patients died from treatment-related adverse events. INTERPRETATION: In patients with advanced melanoma, ipilimumab 10 mg/kg resulted in significantly longer overall survival than did ipilimumab 3 mg/kg, but with increased treatment-related adverse events. Although the treatment landscape for advanced melanoma has changed since this study was initiated, the clinical use of ipilimumab in refractory patients with unmet medical needs could warrant further assessment. FUNDING: Bristol-Myers Squibb.
[Mh] Termos MeSH primário: Anticorpos Monoclonais/administração & dosagem
Antineoplásicos/administração & dosagem
Melanoma/tratamento farmacológico
[Mh] Termos MeSH secundário: Idoso
Alanina Transaminase/sangue
Anticorpos Monoclonais/efeitos adversos
Antineoplásicos/efeitos adversos
Colite/induzido quimicamente
Diarreia/induzido quimicamente
Método Duplo-Cego
Feminino
Seguimentos
Seres Humanos
Hipofisite/induzido quimicamente
Análise de Intenção de Tratamento
Ipilimumab
Masculino
Melanoma/secundário
Meia-Idade
Taxa de Sobrevida
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE III; COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Antibodies, Monoclonal); 0 (Antineoplastic Agents); 0 (Ipilimumab); EC 2.6.1.2 (Alanine Transaminase)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170401
[St] Status:MEDLINE


  7 / 28 MEDLINE  
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[PMID]:28315541
[Au] Autor:Vazquez A
[Ad] Endereço:University of Miami.
[Ti] Título:Hypophysitis: Nursing Management of Immune-Related Adverse Events
.
[So] Source:Clin J Oncol Nurs;21(2):154-156, 2017 Apr 01.
[Is] ISSN:1538-067X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Immunotherapy can treat cancer and prevent future cancer relapse by enhancing the body's immune system. With novel immunotherapeutic agents like checkpoint inhibitors come unique immune-related adverse events. Hypophysitis, one of the lesser known immune-related complications, may be observed in patients receiving checkpoint inhibitors. Although the acute symptoms of immune-related hypophysitis may be managed with attentive monitoring and high-dose corticosteroids, lifelong hormone substitution therapy may be warranted. Oncology nurses are responsible for educating themselves and their patients on the complications of immunotherapy.
.
[Mh] Termos MeSH primário: Anticorpos Monoclonais/efeitos adversos
Anticorpos Monoclonais/uso terapêutico
Antineoplásicos/efeitos adversos
Hipofisite/induzido quimicamente
Hipofisite/enfermagem
Imunoterapia/efeitos adversos
Melanoma/imunologia
[Mh] Termos MeSH secundário: Antineoplásicos/uso terapêutico
Feminino
Seres Humanos
Hipofisite/tratamento farmacológico
Melanoma/tratamento farmacológico
Meia-Idade
Doenças da Hipófise/induzido quimicamente
Doenças da Hipófise/diagnóstico
Doenças da Hipófise/terapia
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Monoclonal); 0 (Antineoplastic Agents)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170319
[St] Status:MEDLINE
[do] DOI:10.1188/17.CJON.154-156


  8 / 28 MEDLINE  
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[PMID]:28258131
[Au] Autor:Pekic S; Popovic V
[Ad] Endereço:School of MedicineUniversity of Belgrade, Belgrade, Serbia.
[Ti] Título:DIAGNOSIS OF ENDOCRINE DISEASE: Expanding the cause of hypopituitarism.
[So] Source:Eur J Endocrinol;176(6):R269-R282, 2017 Jun.
[Is] ISSN:1479-683X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Hypopituitarism is defined as one or more pituitary hormone deficits due to a lesion in the hypothalamic-pituitary region. By far, the most common cause of hypopituitarism associated with a sellar mass is a pituitary adenoma. A high index of suspicion is required for diagnosing hypopituitarism in several other conditions such as other massess in the sellar and parasellar region, brain damage caused by radiation and by traumatic brain injury, vascular lesions, infiltrative/immunological/inflammatory diseases (lymphocytic hypophysitis, sarcoidosis and hemochromatosis), infectious diseases and genetic disorders. Hypopituitarism may be permanent and progressive with sequential pattern of hormone deficiencies (radiation-induced hypopituitarism) or transient after traumatic brain injury with possible recovery occurring years from the initial event. In recent years, there is increased reporting of less common and less reported causes of hypopituitarism with its delayed diagnosis. The aim of this review is to summarize the published data and to allow earlier identification of populations at risk of hypopituitarism as optimal hormonal replacement may significantly improve their quality of life and life expectancy.
[Mh] Termos MeSH primário: Adenoma/diagnóstico
Irradiação Craniana/efeitos adversos
Hipofisite/diagnóstico
Hipopituitarismo/diagnóstico
Neoplasias Hipofisárias/diagnóstico
[Mh] Termos MeSH secundário: Adenoma/complicações
Abscesso Encefálico/complicações
Abscesso Encefálico/diagnóstico
Lesões Encefálicas Traumáticas/complicações
Infecções do Sistema Nervoso Central/complicações
Infecções do Sistema Nervoso Central/diagnóstico
Diagnóstico Diferencial
Diagnóstico Precoce
Intervenção Médica Precoce
Doença de Erdheim-Chester/complicações
Doença de Erdheim-Chester/diagnóstico
Tumor Glômico/complicações
Tumor Glômico/diagnóstico
Granulomatose com Poliangiite/complicações
Granulomatose com Poliangiite/diagnóstico
Hemocromatose/complicações
Hemocromatose/diagnóstico
Hemossiderose/complicações
Hemossiderose/diagnóstico
Histiocitose de Células de Langerhans/complicações
Histiocitose de Células de Langerhans/diagnóstico
Terapia de Reposição Hormonal
Seres Humanos
Hipofisite/complicações
Hipopituitarismo/tratamento farmacológico
Hipopituitarismo/etiologia
Aneurisma Intracraniano/complicações
Aneurisma Intracraniano/diagnóstico
Linfoma/complicações
Linfoma/diagnóstico
Neurossífilis/complicações
Neurossífilis/diagnóstico
Apoplexia Hipofisária/complicações
Apoplexia Hipofisária/diagnóstico
Neoplasias Hipofisárias/complicações
Neoplasias Hipofisárias/secundário
Plasmocitoma/complicações
Plasmocitoma/diagnóstico
Transtornos Puerperais/diagnóstico
Sarcoidose/complicações
Sarcoidose/diagnóstico
Sela Túrcica
Hemorragia Subaracnóidea/complicações
Hemorragia Subaracnóidea/diagnóstico
Tuberculose do Sistema Nervoso Central/complicações
Tuberculose do Sistema Nervoso Central/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170425
[Lr] Data última revisão:
170425
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170305
[St] Status:MEDLINE
[do] DOI:10.1530/EJE-16-1065


  9 / 28 MEDLINE  
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[PMID]:28241874
[Au] Autor:Rzechorzek NM; Liuti T; Stalin C; Marioni-Henry K
[Ad] Endereço:Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH16 4SB, UK. nina.rzechorzek@ed.ac.uk.
[Ti] Título:Restored vision in a young dog following corticosteroid treatment of presumptive hypophysitis.
[So] Source:BMC Vet Res;13(1):63, 2017 Feb 28.
[Is] ISSN:1746-6148
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Hypophysitis is an umbrella term for a group of disorders involving inflammation of the pituitary gland. A rare occurrence in humans, hypophysitis can produce a range of clinical signs including (but not limited to) visual deficits and diabetes insipidus. Only five cases of canine hypophysitis exist in the literature, all presenting in mature dogs with no visual deficits and a grave outcome. This case report describes the clinical and advanced imaging features of blindness-inducing presumptive hypophysitis in a dog, which rapidly resolved with medical management. CASE PRESENTATION: A 1-year-and-seven-month-old neutered male Standard Poodle presented with subacute blindness, ataxia, and polyuria/polydipsia (PUPD). Magnetic resonance imaging (MRI) detected a contrast-enhancing pituitary mass with perilesional oedema compromising the optic chiasm. Suspecting neoplasia, anti-inflammatory corticosteroid was commenced prior to radiation therapy planning. Complete resolution of neurological and visual deficits occurred within 12 days of starting steroid treatment. Repeated advanced imaging indicated macroscopic resolution of the lesion. An extended thyroid panel with insulin-like growth factor-1 analysis supported a diagnosis of hypophysitis. Resolution of PUPD was achieved with tapering courses of prednisolone and desmopressin; the dog has since been clinically normal for 14 months and treatment-free for 11 months. CONCLUSIONS: To the authors' knowledge, this is the first instance in which a canine pituitary mass has demonstrated long-term resolution with palliative medical treatment alone, alongside reversal of associated blindness and presumptive diabetes insipidus. We suspect this lesion to be a form of hypophysitis, which should be included among differential diagnoses for pituitary masses, and for subacute blindness in dogs. Where possible, we advocate biopsy-confirmation of hypophysitis prior to timely intervention with anti-inflammatory treatment.
[Mh] Termos MeSH primário: Corticosteroides/uso terapêutico
Doenças do Cão/tratamento farmacológico
Hipofisite/veterinária
Transtornos da Visão/veterinária
[Mh] Termos MeSH secundário: Animais
Cães
Hipofisite/complicações
Hipofisite/tratamento farmacológico
Masculino
Resultado do Tratamento
Transtornos da Visão/tratamento farmacológico
Transtornos da Visão/etiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Adrenal Cortex Hormones)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170313
[Lr] Data última revisão:
170313
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170301
[St] Status:MEDLINE
[do] DOI:10.1186/s12917-017-0983-x


  10 / 28 MEDLINE  
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[PMID]:28236350
[Au] Autor:Kleinschmidt-DeMasters BK; Lillehei KO; Hankinson TC
[Ad] Endereço:Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, CO.
[Ti] Título:Review of xanthomatous lesions of the sella.
[So] Source:Brain Pathol;27(3):377-395, 2017 May.
[Is] ISSN:1750-3639
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:Xanthomatous lesions of the sellar region have traditionally been divided into two separate categories, xanthomatous hypophysitis (XH) and xanthogranuloma (XG) of the sellar region. The seminal article on XH, a condition typified by foamy histiocytes and lymphoplasmacytic infiltrates in the pituitary gland/sellar region, but usually little or no hemosiderin pigment, detailed three patients. However, most reports since that time have been single cases, making understanding of the entity difficult. In contrast, the seminal report on XG, characterized by sellar region cholesterol clefts, lymphoplasmacytic infiltrates, marked hemosiderin deposits, fibrosis, multinucleated giant cells around cholesterol clefts, eosinophilic granular necrotic debris, and accumulation of macrophages, included 37 patients, allowing more insights into etiology. Few examples could be linked to adamantinomatous craniopharyngioma, and although ciliated epithelium similar to that of Rathke cleft cyst (RCC) was identified up to 35% of the 37 cases, it could not be proven that XG was related to hemorrhage into RCC. Case reports since that time, however, occasionally linked XG to RCC when an etiology could be identified at all, and a few recognized that a spectrum exists in xanthomatous lesions of the sella. They review literature, adding 23 cases from our own experience, to confirm that overlap occurs between XH and XG, and that the majority-but not all-can be linked to RCC leakage/rupture/hemorrhage. It was suggested that progressive accumulation of hemosiderin pigment in the lesion, possibly caused by the multiple episodes of bleeding, could account for the transition of at least some cases of XH to XG.
[Mh] Termos MeSH primário: Doenças da Hipófise/epidemiologia
Doenças da Hipófise/patologia
Sela Túrcica
Xantomatose/epidemiologia
Xantomatose/patologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Encéfalo/diagnóstico por imagem
Criança
Pré-Escolar
Estudos de Coortes
Feminino
Granuloma/diagnóstico por imagem
Granuloma/epidemiologia
Granuloma/patologia
Granuloma/terapia
Seres Humanos
Hipofisite
Masculino
Meia-Idade
Doenças da Hipófise/diagnóstico por imagem
Doenças da Hipófise/terapia
Xantomatose/diagnóstico por imagem
Xantomatose/terapia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170424
[Lr] Data última revisão:
170424
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170226
[St] Status:MEDLINE
[do] DOI:10.1111/bpa.12498



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