Evidence map›Paper›PMID 40571586›Full record

ReviewEndocrine journal2025

Histologically confirmed immunoglobulin G4-related hypophysitis in an adolescent girl: a case report with review of literature.

Yuto Shimizu, Yuri Mukoyama, Fumihiko Takizawa, Atsushi Ogawa, Tetsushi Ogawa, Noriaki Fukuhara, Masahiko Tosaka, Hiroshi Nishioka, Shinji Ito, Yoichiro Oda and 1 more

Abstract readCase ReportsReview
In one paragraph

Review in Endocrine journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Immune-Mediated Hypophysitis: An Updated Review.Journal of clinical medicine · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Yuto ShimizuDepartment of Pediatrics, Toranomon Hospital, Tokyo 105-8470, Japan.
Yuri MukoyamaDepartment of Pediatrics, Toranomon Hospital, Tokyo 105-8470, Japan.
Fumihiko TakizawaDepartment of Pediatrics, Toranomon Hospital, Tokyo 105-8470, Japan.
Atsushi OgawaDepartment of Pediatrics, Toranomon Hospital, Tokyo 105-8470, Japan.
Tetsushi OgawaDepartment of Pediatrics, Toranomon Hospital, Tokyo 105-8470, Japan.
Noriaki FukuharaDepartment of Hypothalamic and Pituitary Surgery, Toranomon Hospital, Tokyo 105-8470, Japan.
Masahiko TosakaDepartment of Hypothalamic and Pituitary Surgery, Toranomon Hospital, Tokyo 105-8470, Japan.
Hiroshi NishiokaDepartment of Hypothalamic and Pituitary Surgery, Toranomon Hospital, Tokyo 105-8470, Japan.
Shinji ItoDepartment of Pathology, Toranomon Hospital, Tokyo 105-8470, Japan.
Yoichiro OdaDepartment of Pediatrics, Chigasaki Municipal Hospital, Chigasaki 253-0042, Japan.
Tsuyoshi IsojimaDepartment of Pediatrics, Toranomon Hospital, Tokyo 105-8470, Japan.ORCID http://orcid.org/0000-0003-0011-0325

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Hypophysitis is an extremely rare inflammatory condition in children that affects the pituitary gland and infundibulum. Immunoglobulin G4-related hypophysitis (IgG4-RH) is an IgG4-related disease (IgG4-RD) typified by the infiltration of IgG4-positive plasma cells into the pituitary gland, leading to fibrosis and damage. Although IgG4-RD was recently recognized as a defined clinical entity, pediatric cases of IgG4-RD are extremely rare. This report describes a histologically confirmed case of IgG4-RH in a 13-year-old girl. The patient became anorectic after several months of nonspecific symptoms such as headache and fatigue. Detailed examinations, including brain computed tomography (CT), did not detect any causes. However, repeated brain CT revealed pituitary enlargement. Further investigations identified an elevated serum IgG4 level (234 mg/dL, normal range: <118 mg/dL). Pituitary biopsy revealed increased IgG4-positive plasma cell counts in the anterior pituitary gland, fulfilling the diagnostic criteria for IgG4-RH. Steroid treatment dramatically improved her symptoms and reversed pituitary enlargement. A literature review identified 128 pediatric cases of IgG4-RD but only seven cases of pediatric IgG4-RH including our case. Although ophthalmic disease was the most common manifestation, broad clinical presentations were observed, even in pediatric cases. A slight female predominance was suggested in pediatric populations with IgG4-RD, whereas a male predominance was reported in adults. Pediatricians should consider IgG4-RH in the differential diagnosis when encountering patients with nonspecific symptoms because early diagnosis could improve the prognosis of pituitary function. Consequently, necessitating the diseases awareness.

Indexed as

Autoimmune HypophysitisImmunoglobulin GImmunoglobulin G4-Related DiseaseAdolescentFemaleHumansPituitary GlandImmunoglobulin GBrain computed tomographyPediatric immunoglobulin G4-related diseasePediatric immunoglobulin G4-related hypophysitisPituitary enlargement

Identifiers

PMID40571586
PMCPMC12624290

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.