{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T05:46:27Z","timestamp":1785822387444,"version":"3.56.0"},"reference-count":29,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lupus\u2010associated hypophysitis is a rare but clinically important manifestation of systemic lupus erythematosus (SLE), characterised by heterogeneous pituitary dysfunction and inflammatory sellar changes that may mimic other pituitary disorders. Evidence is limited to isolated reports. We aimed to summarise clinical, radiological, endocrine features, management, and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A narrative systematic review of MEDLINE, Embase, Web of Science, and Google Scholar to 10 November 2025. Reports were included if accepted SLE criteria were met and hypophysitis or hypothalamic\u2013pituitary inflammation was attributed to SLE after exclusion of alternative sellar pathology. Demographic, clinical, endocrine, imaging, treatment, and outcome data were synthesised descriptively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eleven cases (63% female; median age 23 years) were identified, most presenting at or near SLE diagnosis. Common symptoms included polyuria\/polydipsia, fatigue, amenorrhoea, and headache. Arginine vasopressin deficiency (AVP\u2010D) frequently coexisted with multi\u2010axis anterior hypopituitarism. MRI typically demonstrated pituitary stalk thickening, gland enlargement, and loss of the posterior pituitary bright spot. High\u2010dose glucocorticoids, with or without additional immunosuppression, led to improvement in most cases, although persistent adrenal and gonadal deficits were common; one patient died from severe hyponatraemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Lupus\u2010associated hypophysitis is a rare manifestation of SLE with heterogeneous endocrine and radiological presentations that may create diagnostic challenges. Early endocrine evaluation and pituitary imaging are important in patients with suspected hypothalamic\u2010pituitary involvement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cen.70197","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T05:19:52Z","timestamp":1785820792000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Lupus\u2011Associated Hypophysitis: A Narrative Systematic Review of Clinical, Radiological and Endocrine Features"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2431-2231","authenticated-orcid":false,"given":"Abdellatif","family":"Zhalka","sequence":"first","affiliation":[{"name":"Department of Internal Medicine B Haemek Medical Center Afula Israel"},{"name":"Department of Endocrinology Haemek Medical Center Afula Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3292-2099","authenticated-orcid":false,"given":"Shadi","family":"Shinnawi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California\u2010Davis Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rami","family":"Jabareen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine B Haemek Medical Center Afula Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Awad","family":"Karem","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension Haemek Medical Center Afula Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Zahlaka","sequence":"additional","affiliation":[{"name":"Department of Ear, Nose and Throat and Head and Neck Surgery, Wolfson Medical Center Gray Faculty of Medicine Tel Aviv University Sackler Holon Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"issue":"8","key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.3390\/jpm13081210","article-title":"Unveiling the Etiopathogenic Spectrum of Hypophysitis: A Narrative Review","volume":"13","author":"Menotti S.","year":"2023","journal-title":"Journal of Personalized Medicine"},{"issue":"1","key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1210\/clinem\/dgab672","article-title":"Hypophysitis, the Growing Spectrum of a Rare Pituitary Disease","volume":"107","author":"Langlois F.","year":"2022","journal-title":"Journal of Clinical Endocrinology & Metabolism"},{"issue":"6","key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"5917","DOI":"10.3390\/ijms24065917","article-title":"Hypophysitis: Defining Histopathologic Variants and a Review of Emerging Clinical Causative Entities","volume":"24","author":"Rawanduzy C. A.","year":"2023","journal-title":"International Journal of Molecular Sciences"},{"issue":"3","key":"e_1_2_9_5_1","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1159\/000446544","article-title":"An Overview of Diagnosis of Primary Autoimmune Hypophysitis in a Prospective Single\u2010Center Experience","volume":"104","author":"Chiloiro S.","year":"2017","journal-title":"Neuroendocrinology"},{"issue":"9","key":"e_1_2_9_6_1","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1016\/j.tem.2019.06.004","article-title":"The Changing Clinical Spectrum of Hypophysitis","volume":"30","author":"Chiloiro S.","year":"2019","journal-title":"Trends in Endocrinology & Metabolism"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.2315"},{"issue":"10188","key":"e_1_2_9_8_1","doi-asserted-by":"crossref","first-page":"2344","DOI":"10.1016\/S0140-6736(19)30546-X","article-title":"Novel Paradigms in Systemic Lupus Erythematosus","volume":"393","author":"D\u00f6rner T.","year":"2019","journal-title":"Lancet"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00398-2"},{"key":"e_1_2_9_10_1","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.jaut.2014.01.004","article-title":"Diagnostic Criteria for Systemic Lupus Erythematosus: A Critical Review","volume":"48","author":"Yu C.","year":"2014","journal-title":"Journal of Autoimmunity"},{"issue":"4","key":"e_1_2_9_11_1","doi-asserted-by":"crossref","first-page":"582","DOI":"10.2169\/naika.82.582","article-title":"A Case of Systemic Lupus Erythematosus Which Contracted Autoimmune Pituitary Glanditis","volume":"82","author":"Hasegawa Y.","year":"1993","journal-title":"Nihon Naika Gakkai Zasshi"},{"issue":"8","key":"e_1_2_9_12_1","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1191\/096120398678920514","article-title":"Visual Disturbance by Lymphocytic Hypophysitis in a Non\u2010Pregnant Woman With Systemic Lupus Erythematosus","volume":"7","author":"Katano H.","year":"1998","journal-title":"Lupus"},{"issue":"1","key":"e_1_2_9_13_1","first-page":"78","article-title":"Lymphocytic Hypophysitis in a Patient With Systemic Lupus Erythematosus","volume":"18","author":"Ji J. D.","year":"2000","journal-title":"Clinical and Experimental Rheumatology"},{"issue":"6","key":"e_1_2_9_14_1","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1507\/endocrj.49.605","article-title":"A Case of Lymphocytic Infundibuloneurohypophysitis Associated With Systemic Lupus Erythematosus","volume":"49","author":"Hashimoto K.","year":"2002","journal-title":"Endocrine Journal"},{"issue":"2","key":"e_1_2_9_15_1","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1007\/s12026-020-09118-8","article-title":"Successful Management and Treatment of SLE\u2010Associated Hypophysitis","volume":"68","author":"Zhu L.","year":"2020","journal-title":"Immunologic Research"},{"issue":"4","key":"e_1_2_9_16_1","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1507\/endocrj.EJ19-0569","article-title":"Diagnosis and Treatment of Autoimmune and IgG4\u2010related Hypophysitis: Clinical Guidelines of the Japan Endocrine Society","volume":"67","author":"Takagi H.","year":"2020","journal-title":"Endocrine Journal"},{"key":"e_1_2_9_17_1","first-page":"OC10","article-title":"Autoimmune Hypothalamitis and Hypophysitis Due to SLE Manifesting as Arginine Vasopressin Deficiency and Hypothalamic Hyperphagia","volume":"100","author":"Anandhakrishnan A.","year":"2024","journal-title":"Endocrine Abstracts"},{"key":"e_1_2_9_18_1","first-page":"285","article-title":"A Case of Systemic Lupus Erythematosus With Hypophysitis as the First Manifestation","volume":"17","author":"Huang A.","year":"2013","journal-title":"Chinese Journal of Rheumatology"},{"key":"e_1_2_9_19_1","first-page":"221","article-title":"A Teenager Diagnosed as Lymphocytic Hypophysitis Associated With Systemic Lupus Erythematosus (SLE)","volume":"5","author":"Jing E.","year":"2014","journal-title":"Journal of Blood Disorders & Transfusion"},{"key":"e_1_2_9_20_1","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2020.579436","article-title":"Autoimmune Hypophysitis With Systemic Lupus Erythematosus: A Case Report and Literature Review","volume":"11","author":"Xiang P.","year":"2020","journal-title":"Frontiers in Endocrinology"},{"key":"e_1_2_9_21_1","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1007\/s13312-021-2106-9","article-title":"Autoimmune Hypophysitis in Systemic Lupus Erythematosus","volume":"58","author":"Kapur S.","year":"2021","journal-title":"Indian Pediatrics"},{"issue":"5","key":"e_1_2_9_22_1","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1080\/03009742.2020.1861648","article-title":"Hypophysitis Identified on Initial Presentation of Systemic Lupus Erythematosus: A Case Report and Review of the Literature","volume":"50","author":"Yoshihara R.","year":"2021","journal-title":"Scandinavian Journal of Rheumatology"},{"issue":"9","key":"e_1_2_9_23_1","article-title":"Lupus\u2010Associated Autoimmune Hypophysitis: A Rare Case","volume":"17","author":"Abdellatif Z.","year":"2025","journal-title":"Cureus"},{"issue":"4","key":"e_1_2_9_24_1","doi-asserted-by":"crossref","first-page":"541","DOI":"10.3899\/jrheum.161313","article-title":"Refractory Syndrome of Inappropriate Secretion of Antidiuretic Hormone in Systemic Lupus Erythematosus\u2010Associated Hypophysitis","volume":"44","author":"Yang N.","year":"2017","journal-title":"Journal of Rheumatology"},{"issue":"3","key":"e_1_2_9_25_1","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1159\/000446544","article-title":"An Overview of Diagnosis of Primary Autoimmune Hypophysitis in a Prospective Single\u2010Center Experience","volume":"104","author":"Chiloiro S.","year":"2017","journal-title":"Neuroendocrinology"},{"issue":"1","key":"e_1_2_9_26_1","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1210\/clinem\/dgab672","article-title":"Hypophysitis, the Growing Spectrum of a Rare Pituitary Disease","volume":"107","author":"Langlois F.","year":"2022","journal-title":"Journal of 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Factors Predicting Responsiveness to Glucocorticoid Therapy: A Prospective and Double\u2010Arm Study","volume":"103","author":"Chiloiro S.","year":"2018","journal-title":"Journal of Clinical Endocrinology & Metabolism"}],"container-title":["Clinical 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