Papers of the Week

Hypophysitis is considered a rare inflammatory disease of the pituitary. For a long time, primary autoimmune hypophysitis (PAH) stood out as the most relevant type of hypophysitis. However, with the advent on immunotherapy for the treatment of malignancy and identification of hypophysitis as an immune related adverse event, hypophysitis has garnered increasing interest and recognition. Therefore awareness, early recognition, and appropriate management is important as the indication for immunomodulatory therapies broaden. Regardless of cause, symptoms and signs may be related to mass effect (headache, visual disturbance) and hormonal disruption which warrant prompt evaluation. In the vast majority, a diagnosis of hypophysitis can be made presumptively in the appropriate clinical context with radiological findings consistent with hypophysitis and following the exclusion of other causes. Although subtle differences currently exist in management and outcomes expectations between primary and secondary causes of hypophysitis, universally, treatment is aimed at symptom management and hormonal replacement. In this review we discuss the epidemiology, diagnosis, and treatment of hypophysitis with a focus on recent data and highlight subtypes of particular interest while recognizing the gaps in knowledge that remain.