Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2025 Jun 26;17(6):e86780.
doi: 10.7759/cureus.86780. eCollection 2025 Jun.

Infertility as a Rare Manifestation of Pituitary Involvement in Granulomatosis With Polyangiitis: A Case Report

Mohammad Syedul Islam  1 , Quazi Mamtaz Uddin Ahmed  1 , Farzana Ahmed  2 , Md Ashraf Uddin  1 , Naznin Naher  1
Affiliations
Case Reports

Infertility as a Rare Manifestation of Pituitary Involvement in Granulomatosis With Polyangiitis: A Case Report

Mohammad Syedul Islam et al. Cureus. .

Abstract

Granulomatosis with polyangiitis is a rare autoimmune disease that affects small-sized blood vessels. It most commonly involves the lungs, kidneys, and the areas around the nose and throat, but can also affect other organs, including the nervous system. Enlargement of the pituitary gland may cause a mass effect, and pituitary dysfunction can occur. Among pituitary hormone abnormalities, hypogonadotropic hypogonadism is more common than other hormonal deficiencies. Pituitary involvement may arise at any stage of the disease, sometimes even as the initial presentation. We report a rare case of granulomatosis with polyangiitis with pituitary dysfunction presenting as infertility, along with pulmonary and systemic manifestations.

Keywords: anca associated vasculitis; cyclophosphamide therapy; hypogonadotropic hypogonadism; infertility; pituitary dysfunction.

PubMed Disclaimer

Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Bilateral periorbital swelling and conjunctival injection with chemosis, consistent with scleritis in a patient with GPA
GPA: granulomatosis with polyangiitis
Figure 2
Figure 2. The arrows indicate multiple thick-walled cavitary lesions in the right mid-zone and the left lung field
The cavities vary in size and have irregular, well-defined thick walls.
Figure 3
Figure 3. High-resolution computed tomography (HRCT) chest images (a–d) showing characteristic pulmonary findings in GPA
Axial (3a, 3b) and coronal (3c, 3d) views reveal multiple thick-walled cavitary nodules (red arrows) in both lungs. These findings are suggestive of necrotizing granulomatous inflammation, typical of GPA-related pulmonary involvement. GPA: granulomatosis with polyangiitis
Figure 4
Figure 4. Sagittal T1-weighted contrast-enhanced MRI brain images (a–c) showing pituitary involvement in GPA
The images reveal a homogeneously enhancing sellar mass with peripheral rim enhancement (red arrows), thickening of the pituitary stalk, and mild superior compression of the optic chiasm. GPA: granulomatosis with polyangiitis
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Epidemiology of ANCA-associated vasculitis. Ntatsaki E, Watts RA, Scott DG. https://www.rheumatic.theclinics.com/article/S0889-857X(10)00038-4/abstract. Rheum Dis Clin North Am. 2010;36:447–461. - PubMed
    1. Childhood-onset granulomatosis with polyangiitis and microscopic polyangiitis: systematic review and meta-analysis. Iudici M, Quartier P, Terrier B, Mouthon L, Guillevin L, Puéchal X. Orphanet J Rare Dis. 2016;11:141. - PMC - PubMed
    1. ANCA-associated vasculitis. Kitching AR, Anders HJ, Basu N, et al. Nat Rev Dis Primers. 2020;6:71. - PubMed
    1. Pituitary involvement in granulomatosis with polyangiitis. Report of 9 patients and review of the literature. De Parisot A, Puéchal X, Langrand C, et al. Medicine (Baltimore) 2015;94:0. - PMC - PubMed
    1. Pituitary involvement in patients with granulomatosis with polyangiitis: case series and literature review. Gu Y, Sun X, Peng M, Zhang T, Shi J, Mao J. Rheumatol Int. 2019;39:1467–1476. - PubMed

Publication types

LinkOut - more resources