Clinical features of anti-pituitary-specific transcription factor-1 (PIT-1) hypophysitis: a new aspect of paraneoplastic autoimmune condition

Eur J Endocrinol. 2024 Jan 3;190(1):K1-K7. doi: 10.1093/ejendo/lvad179.

Abstract

The pathogenesis of anti-pituitary-specific transcription factor-1 (PIT-1) hypophysitis was gradually revealed as cases emerged. Our comprehensive analysis, including all reported cases, identified a new instance of anti-PIT-1 hypophysitis postimmune checkpoint inhibitor therapy. All 9 patients exhibited extremely low growth hormone (GH), prolactin (PRL), and thyroid-stimulating hormone (TSH) levels; 2 had a slightly atrophic pituitary gland; 4 had thymoma, and 5 had malignant neoplasms of diffuse large B-cell lymphoma (DLBCL) and other origins. Patients with thymoma showed multiple autoimmune diseases. HLA-A*24:02 and/or A*02:06 were present in six and DR53 in 5 cases analyzed. High anti-PIT-1 antibody titers and ectopic PIT-1 expression in the cytosol and nucleus of the tumor tissues were observed in patients with thymoma or DLBCL, whereas it was exclusively observed in the nuclei of a bladder cancer patient. These findings provide new insights into the pathophysiology of paraneoplastic autoimmune hypophysitis.

Keywords: PIT-1; POU1F1; anti-PIT-1 hypophysitis; immune checkpoint inhibitor-related hypophysitis; paraneoplastic syndrome.

MeSH terms

  • Autoantibodies
  • Autoimmune Diseases*
  • Autoimmune Hypophysitis*
  • Humans
  • Hypophysitis*
  • Thymoma*
  • Thymus Neoplasms*
  • Transcription Factor Pit-1
  • Transcription Factors

Substances

  • Autoantibodies
  • Transcription Factor Pit-1
  • Transcription Factors
  • POU1F1 protein, human