Primary Autoimmune Hypophysitis: Treatment and Predictors of Response to Glucocorticoid in a Single Center in China.

OBJECTIVE

To report clinical characteristics, treatment, and outcome of primary autoimmune hypophysitis (PAH), and to explore predictors of response to glucocorticoid (GC) therapy.

METHODS

Seventy-seven patients diagnosed with PAH in our institute from December 2009 to October 2022 were included. Clinical symptoms, endocrine, and radiological features and treatment were reviewed. Endocrine and radiological outcome was evaluated, and logistic regression was conducted to explore the predictor of responsiveness to GC therapy.

RESULTS

Headache (64.9%) was the most common clinical symptom. Hypogonadotropic hypogonadism (58.9%) was the most common anterior pituitary deficiency, followed by secondary hypocortisolism (57.1%) and secondary hypothyroidism (52.6%). Vasopressin deficiency was observed in 61.8% of the patients. Radiological recovery/improvement was significantly more common in patients who received GC therapy than in those who did not (39/48, 81.3% vs 11/20, 55.0%, P = .025). Younger age at diagnosis was an independent favorable factor for endocrine response to GC (odds ratio = 0.897 [0.808, 0.995], P = .040). The presence of growth hormone deficiency was an independent unfavorable factor for radiological response to GC (odds ratio = 0.094 [0.015, 0.580], P = .011).

CONCLUSION

GC therapy was effective in achieving both endocrine and radiological remission in patients with PAH. Younger patients were more prone to endocrine response to GC therapy, whereas growth hormone deficiency emerged as an independent unfavorable factor for radiological response to GC treatment.