Treatment of Pituitary Lesions in Granulomatosis with Polyangiitis

Induction of Remission

• The American College of Rheumatology recommends rituximab 375 mg/m² weekly for 4 weeks plus high-dose glucocorticoids as first-line treatment for severe Granulomatosis with Polyangiitis (GPA) with pituitary involvement 1
• An alternative treatment is cyclophosphamide 2 mg/kg/day (adjusted for renal function) plus high-dose glucocorticoids 1

Prevention of Infections

• Prophylaxis against Pneumocystis jirovecii is mandatory in all patients receiving rituximab or high-dose immunosuppression 2, 3