{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T02:51:44Z","timestamp":1772160704941,"version":"3.50.1"},"reference-count":51,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,2,21]],"date-time":"2021-02-21T00:00:00Z","timestamp":1613865600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Neuroendocrinology"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>IgG4\u2010related hypophysitis (IgG4\u2010RH) is increasingly being reported as an isolated entity or, less frequently, as a manifestation of a multiorgan IgG4\u2010related disease (IgG4\u2010RD), in which typical histopathology is a cornerstone for the diagnosis. We aimed to describe the histopathological changes in the surgical specimens from patients with clinical signs of pituitary disease that fulfilled the current diagnostic criteria for IgG4\u2010RH. Histopathological features were correlated with clinical and radiological findings. Of 19 patients with pituitary dysfunction and inflammatory changes in the surgical pituitary specimen operated on during 2011\u20102019, we identified five patients with typical IgG4\u2010related pathology (lymphoplasmacytic infiltration with more than 10 IgG4\u2010positive plasma cells per one high power microscopic field, representing at least 40% of all plasma cells and at least focal storiform fibrosis). One patient with diabetes insipidus and pachymeningitis with IgG4\u2010related changes in a biopsy from the dura was also included. Additional histopathological changes that typically are not part of the IgG4\u2010RH were observed: Rathke's cleft cyst in four and granulomatous changes in two patients. One patient had an elevated serum IgG4 level and systemic manifestations that could be associated with the systemic IgG4\u2010RD. Our findings indicate that pure IgG4\u2010RH is uncommon. All patients with pituitary dysfunction, beyond typical IgG4\u2010related pathology, had other pathological findings that could trigger the secondary IgG4\u2010response. Both primary pathology and secondary IgG4\u2010related features should be reported in patients with pituitary dysfunction because their co\u2010occurrence may cause atypical clinical and imaging features, and unexpected response to surgical and pharmacological treatment. The current criteria for the diagnosis of IgG4\u2010RH can lead to overdiagnosis of IgG4\u2010RH if additional pathological changes are not taken into consideration. The classification criteria of IgG4\u2010RD proposed by the American College of Rheumatology\/European League Against Rheumatism could help classify patients more properly as IgG4\u2010RH if applied to the pituitary gland.<\/jats:p>","DOI":"10.1111\/jne.12942","type":"journal-article","created":{"date-parts":[[2021,2,22]],"date-time":"2021-02-22T01:40:40Z","timestamp":1613958040000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Histopathological findings in the landscape of IgG4\u2010related pathology in patients with pituitary dysfunction: Review of six cases"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6715-3704","authenticated-orcid":false,"given":"Lilian","family":"Vasaitis","sequence":"first","affiliation":[{"name":"Department of Medical Sciences, Rheumatology Uppsala University Uppsala 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