自身免疫性垂体炎的再认识  

Re-cognization of autoimmune hypophysitis

作　　者：徐甜 翟笑 朱惠娟[1] XU Tian;ZHAI Xiao;ZHU Hui-juan(Key Laboratory of Endocrinology of National Health Commission,Department of Endocrinology,State Key Laboratory of Complex Severe and Rare Diseases Peking Union Medical College Hospital,Chinese Academy of Medical Science and Peking Union Medical College)

机构地区：[1]中国医学科学院北京协和医学院、北京协和医院内分泌科、卫健委内分泌重点实验室、疑难重症及罕见病国家重点实验室,北京100730

出　　处：《中国实用内科杂志》2024年第11期906-910,共5页Chinese Journal of Practical Internal Medicine

基　　金：中国医学科学院医学与健康科技创新工程项目(2022-I2M-C&T-B-007)。

摘　　要：自身免疫性垂体炎是下丘脑垂体器官特异性自身免疫性罕见疾病,免疫细胞的浸润不同程度上破坏垂体功能,还会导致部分患者垂体增大压迫周围组织器官,出现严重的临床症状,甚至危及生命。随着对自身免疫垂体炎认识的深入,各种病因被不断揭示,也指导临床诊疗决策。虽然淋巴细胞垂体炎仍是较为常见的类型,但随着免疫检查点抑制剂在恶性肿瘤临床的广泛应用,垂体炎作为自身免疫相关不良反应之一逐渐被认识。副肿瘤综合征相关垂体炎是容易漏诊和误诊的自身免疫性垂体炎的类型,及时的诊断和治疗对改善患者的预后具有重要临床意义。文章旨在总结免疫检查点抑制剂导致免疫不良反应相关垂体炎和副肿瘤综合征相关垂体炎的临床特点和诊治原则,以推动对此类罕见垂体炎类型的认识。Autoimmune hypophysitis is a rare organ-specific autoimmune disorder affecting the hypothalamus and pituitary gland,characterized by the infiltration of immune cells that impairs pituitary function to varying degreesand leads to pituitary enlargement in some patients,which may press adjacent tissues and organs,resulting in severe clinical manifestations and potentially life-threatening conditions.With a deeper understanding of autoimmune hypophysitis,more etiologies are being revealed,which in turn guides clinical decisions diagnosis and treatment.Although lymphocytic hypophysitis remains a relatively common type,the widespread use of immune checkpoint inhibitors in the treatment of malignant tumors has led to a growing recognition of hypophysitis as an immune-related adverse event.Paraneoplastic syndrome-associated hypophysitis is a type of autoimmune hypophysitis that is prone to misdiagnosis and underdiagnosis.Therefore,timely diagnosis and treatment is of great significance in improving patient prognosis in clinical practice.This paper aims to summarize the clinical features and,treatment and diagnosis principles of hypophysitis as an immune-related adverse event of immune checkpoint inhibitors and paraneoplastic syndrome related hypophysitis,in order to promote the recognition of such rare types of hypophysitis.

关 键 词：自身免疫性垂体炎 淋巴细胞垂体炎 免疫检查点抑制剂 副肿瘤综合征 

分 类 号：R58[医药卫生—内分泌]