Alameri M, Alnuaimi A, Martin NM, Meeran K, Gontsarova A, Barwick TD, Ellis S, McAdoo S, Tomlinson J, Wernig F. Pituitary hypophysitis in granulomatosis with polyangiitis (GPA): a case series.
Pituitary 2024;
27:230-237. [PMID:
38296897 PMCID:
PMC11009729 DOI:
10.1007/s11102-023-01378-5]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/24/2023] [Indexed: 02/02/2024]
Abstract
Granulomatosis with polyangiitis (GPA) rarely involves the pituitary gland. Pituitary involvement has been reported in ~ 1% of all cases of GPA. Most commonly, pituitary swelling and inflammation results in symptoms due to pituitary mass effect and arginine vasopressin deficiency. To date, there are no pituitary-specific treatment guidelines for this rare condition. We present three patients with GPA-related hypophysitis highlighting the spectrum of pituitary involvement. All three patients were successfully treated with immunosuppressive regimens that included rituximab (RTX). Following remission induction with high-dose glucocorticoids, patients received 6 monthly RTX for remission maintenance. RTX was well tolerated without significant side effects.
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