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Open Access 31-01-2024 | Granulomatosis with Polyangiitis

Pituitary hypophysitis in granulomatosis with polyangiitis (GPA): a case series

Authors: Majid Alameri, Abdulla Alnuaimi, Niamh M. Martin, Karim Meeran, Anastasia Gontsarova, Tara D. Barwick, Spencer Ellis, Stephen McAdoo, James Tomlinson, Florian Wernig

Published in: Pituitary | Issue 2/2024

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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Title: Pituitary hypophysitis in granulomatosis with polyangiitis (GPA): a case series
Authors: Majid Alameri
Abdulla Alnuaimi
Niamh M. Martin
Karim Meeran
Anastasia Gontsarova
Tara D. Barwick
Spencer Ellis
Stephen McAdoo
James Tomlinson
Florian Wernig
Publication date: 31-01-2024
Publisher: Springer US
Keywords: Granulomatosis with Polyangiitis
Granulomatosis with Polyangiitis
Rituximab
Rituximab
Hypophysitis
Glucocorticoid
Prednisolone
ANCA-Associated Vasculitis
ANCA-Associated Vasculitis
Published in: Pituitary / Issue 2/2024
Print ISSN: 1386-341X
Electronic ISSN: 1573-7403
DOI: https://doi.org/10.1007/s11102-023-01378-5

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