Granulomatosis With Polyangiitis Manifesting as a Symptomatic Pituitary Mass in a Young Woman

Granulomatosis with polyangiitis (GPA) is a small-to medium-sized blood vessel vasculitis that commonly affects the upper and lower respiratory tract, kidneys, eyes, nose, and ears. Pituitary involvement in GPA is rare, seen in about 1% of cases. Here, we discuss a young woman presenting with headache and diplopia in the setting of pituitary masses. Despite transsphenoidal resections and intravenous antibiotics, her symptoms progressed. She developed visual field defects, nasal crusting, and dyspnea with cavitary lung lesions and nodules. The diagnosis of GPA was established through pathology, radiographic findings, laboratory results, clinical history, and response to steroids and rituximab induction therapy.