TY  - BOOK
AU  - Haberstroh, William
AU  - Lenka, Abhishek
TI  - Relapsed granulomatosis with polyangiitis with panhypopituitarism
SN  - 1757-790X
PY  - 2021///
KW  - *Adrenal Insufficiency/di [Diagnosis]
KW  - *Diabetes Insipidus/di [Diagnosis]
KW  - *Granulomatosis with Polyangiitis/dg [Diagnostic Imaging]
KW  - *Hypogonadism/di [Diagnosis]
KW  - *Hypopituitarism/di [Diagnosis]
KW  - *Hypothyroidism/di [Diagnosis]
KW  - *Rhinitis/dg [Diagnostic Imaging]
KW  - *Sinusitis/dg [Diagnostic Imaging]
KW  - Adrenal Insufficiency/dt [Drug Therapy]
KW  - Adrenal Insufficiency/et [Etiology]
KW  - Androgens/tu [Therapeutic Use]
KW  - Diabetes Insipidus/et [Etiology]
KW  - Fatigue/et [Etiology]
KW  - Glucocorticoids/tu [Therapeutic Use]
KW  - Granulomatosis with Polyangiitis/co [Complications]
KW  - Granulomatosis with Polyangiitis/dt [Drug Therapy]
KW  - Granulomatosis with Polyangiitis/pa [Pathology]
KW  - Hormone Replacement Therapy
KW  - Humans
KW  - Hypogonadism/dt [Drug Therapy]
KW  - Hypogonadism/et [Etiology]
KW  - Hypopituitarism/dt [Drug Therapy]
KW  - Hypopituitarism/et [Etiology]
KW  - Hypothyroidism/dt [Drug Therapy]
KW  - Hypothyroidism/et [Etiology]
KW  - Immunosuppressive Agents/tu [Therapeutic Use]
KW  - Magnetic Resonance Imaging
KW  - Male
KW  - Methotrexate/tu [Therapeutic Use]
KW  - Middle Aged
KW  - Pituitary Diseases
KW  - Pituitary Gland/dg [Diagnostic Imaging]
KW  - Recurrence
KW  - Rhinitis/pa [Pathology]
KW  - Sella Turcica/dg [Diagnostic Imaging]
KW  - Sinusitis/pa [Pathology]
KW  - Testosterone/tu [Therapeutic Use]
KW  - Thyroxine/tu [Therapeutic Use]
KW  - Weight Loss
KW  - MedStar Washington Hospital Center
KW  - MedStar Georgetown University Hospital Residents
KW  - Neurology
KW  - Journal Article
N2  - A man in his early 60s with a medical history of granulomatosis with polyangiitis (GPA) in remission for two decades without maintenance therapy presented with non-specific complaints of profound fatigue and 40-pound weight loss. He was seronegative for antinuclear antibodies and cytoplasmic antineutrophilic antibodies, but erythrocyte sedimentation rate and C reactive protein levels were elevated. Endocrinological testing revealed adrenal insufficiency, hypogonadism, hypothyroidism and diabetes insipidus. An MRI of the head revealed extensive sinonasal inflammation eroding through the floor of the sella turcica and into the pituitary gland and stalk. Biopsy of the sinonasal tissues was inconclusive. On review of his case, a multidisciplinary team diagnosed him with panhypopituitarism secondary to a recurrence of GPA. He responded well to glucocorticoids and methotrexate with marked reduction of pituitary enhancement on imaging and resolution of diabetes insipidus. He will require lifelong testosterone, levothyroxine and glucocorticoids for hormone replacement therapy. Copyright (c) BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ
UR  - https://dx.doi.org/10.1136/bcr-2020-237774
ER  -