Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK.
Department of Radiology, Imperial College Healthcare NHS Trust, London, UK.
Pituitary. 2024 Apr;27(2):230-237. doi: 10.1007/s11102-023-01378-5. Epub 2024 Jan 31.
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.
肉芽肿性多血管炎（GPA）很少累及垂体。据报道，在 GPA 的所有病例中，约有 1%累及垂体。最常见的是，垂体肿胀和炎症导致因垂体肿块效应和精氨酸加压素缺乏而出现症状。迄今为止，针对这种罕见疾病，尚无专门的垂体治疗指南。我们介绍了 3 例 GPA 相关的垂体炎患者，重点阐述了垂体受累的范围。所有 3 例患者均成功接受了免疫抑制治疗方案，包括利妥昔单抗（RTX）。在大剂量糖皮质激素诱导缓解后，患者接受 6 个月的 RTX 以维持缓解。RTX 耐受性良好，无明显副作用。
