Azathioprine as an alternative treatment in primary hypophysitis.
Primary hypophysitis (PH) is an unusual disorder characterized by inflammatory infiltration of the pituitary gland with various degree of pituitary dysfunction. Glucocorticoids are the treatment of choice in the majority of patients. Still, in patients with poor response in glucocorticoids or when their administration is accompanied with serious side effects, the use of alternative agents should be considered; up to now, data on other therapeutic approaches remains scant mainly due to the rarity of the disease. Among them, the immunosuppressant azathioprine could represent an effective and safe alternative. In this article, we present our clinical experience of two cases with PH successfully treated with azathioprine following serious side effects after initial treatment with glucocorticoids and provide a brief review of the existing literature.
Papanastasiou
L
L
Department of Endocrinology and Diabetes Center, Athens General Hospital G. Gennimatas, Athens, Attika, Greece. linapapan@yahoo.gr
Pappa
T
T
Tsiavos
V
V
Tseniklidi
E
E
Androulakis
I
I
Kontogeorgos
G
G
Piaditis
G
G
D000328:Adult; D001379:Azathioprine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008875:Middle Aged; D010900:Pituitary Diseases / Q000188:drug therapy*
D007166:Immunosuppressive Agents; D001379:Azathioprine
Eur J Endocrinol. 2006 Jul;155(1):101-7
16793955
Pituitary. 2006;9(1):35-45
16703407
Ann Intern Med. 1981 Aug;95(2):166-71
7196190
Arthritis Rheum. 1989 Jul;32(7):837-43
2751718
Mayo Clin Proc. 1999 Feb;74(2):150-4
10069353
Intern Med. 2006;45(21):1249-52
17139127
J Neurol Neurosurg Psychiatry. 1999 Sep;67(3):398-402
10449568
J Neurosurg. 2004 Aug;101(2):262-71
15309917
Acta Neuropathol. 1995;90(6):637-44
8615086
Pituitary. 2002 Jan;5(1):37-44
12638725
J Clin Endocrinol Metab. 1995 Aug;80(8):2302-11
7629223
Endocr J. 2003 Dec;50(6):697-702
14709840
J Neurol Neurosurg Psychiatry. 1998 May;64(5):693-4
9598703
Endocr Pathol. 2002 Fall;13(3):183-95
12446917
J Neurosurg. 2010 Jan;112(1):118-21
19558303
Neurosurgery. 1997 Apr;40(4):713-22; discussion 722-3
9092844
Endocr J. 1999 Feb;46(1):187-92
10426586
J Clin Endocrinol Metab. 1999 Mar;84(3):844-52
10084559
J Neurol Neurosurg Psychiatry. 2003 Nov;74(11):1581-3
14617725
J Clin Endocrinol Metab. 1993 Jun;76(6):1499-504
8501157
J Clin Endocrinol Metab. 2001 Mar;86(3):1048-53
11238484
Am J Med. 1985 Jan 21;78(1A):33-8
3970038
J Clin Endocrinol Metab. 1992 Mar;74(3):548-52
1310997
Clin Sci (Lond). 2008 Mar;114(6):413-21
18260829
Endocr J. 1997 Feb;44(1):1-10
9152609
Endocr Rev. 2005 Aug;26(5):599-614
15634713
Ann Med Interne (Paris). 1999 Jun;150(4):327-41
10519020
Pituitary. 2003;6(3):161-8
14971740
Transplantation. 2003 Sep 27;76(6):984-8
14508366
J Neurosurg. 2003 Sep;99(3):591-6
12959451
Medicine (Baltimore). 1989 Jul;68(4):240-56
2661963
J Neurol Neurosurg Psychiatry. 2001 Dec;71(6):798-801
11723207
Gut. 2005 Aug;54(8):1121-5
16009685
Intern Med. 2003 Feb;42(2):168-73
12636236
Eur J Endocrinol. 2003 Nov;149(5):363-76
14585081
ScientificWorldJournal. 2010 Jan 21;10:126-34
20098956