Autoimmune hypophysitis: a study of natural course

Autoimmune hypophysitis is a rare autoimmune endocrinopathy. It is possible that the prevalence of autoimmune hypophysitis is underestimated. 1,2 The reported incidence of autoimmune hypophysitis is one in nine million. 3 A recent study reported an estimated incidence of autoimmune hypophysitis in India as 2.4 per ten million population. 4 Increasing recognition of the disease is contributing for the recent increase in the incidence. In addition to the spontaneously occurring autoimmune hypophysitis cases, a large number of iatrogenic cases have been reported with the use of CTLA4 antibody, ipilimumab. Hypophysitis has been reported in up to 17% melanoma cases treated with ipilimumab. 5 With the increasing use of ipilimumab in the treatment of melanoma, addition of these iatrogenic autoimmune hypophysitis cases may further increase the incidence of autoimmune hypophysistis.