Ectopic Relapse of Anti-neutrophil Cytoplasmic Antibody-associated Pituitary Vasculitis with No Elevation of Anti-neutrophil Cytoplasmic Antibodies after Renal Remission

Reiko Muto; Koji Inagaki; Naokazu Sato; Tetsuro Sameshima; Yuka Nagakura; Satoshi Baba; Noritoshi Kato; Shoichi Maruyama; Toshiyuki Akahori

doi:10.2169/internalmedicine.4731-20

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Ectopic Relapse of Anti-neutrophil Cytoplasmic Antibody-associated Pituitary Vasculitis with No Elevation of Anti-neutrophil Cytoplasmic Antibodies after Renal Remission

Reiko Muto, Koji Inagaki, Naokazu Sato, Tetsuro Sameshima, Yuka Nagakura, Satoshi Baba, Noritoshi Kato, Shoichi Maruyama, Toshiyuki Akahori

著者情報

キーワード: ANCA, Vasculitis, pituitary, relapse, ANCA-associated vasculitis

ジャーナルオープンアクセス早期公開

論文ID: 4731-20

DOI https://doi.org/10.2169/internalmedicine.4731-20

この記事には本公開記事があります。

The final version of this article is now available: Vol. 59 (2020), No. 24 pp. 3187-3193

詳細

抄録

The relationship between anti-neutrophil cytoplasmic antibody (ANCA) titer levels and relapse risk in patients with ANCA-associated vasculitis (AAV) following clinical remission remains controversial. We herein report a case showing ectopic relapse of AAV in the pituitary with no ANCA elevation after renal remission. Magnetic resonance imaging revealed an enlarged pituitary gland. A pituitary biopsy showed geographic necrosis with multinucleated giant cells. We diagnosed this case as relapse of AAV in the pituitary. One month after rituximab therapy, the pituitary gland volume had decreased. The intensification of therapy due to the possibility of vasculitis relapse may facilitate better control of AAV.

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