Therapeutic Response to Rituximab in IgG4-Related Hypophysitis Evidenced on 18F-FDG PET and MRI

Clin Nucl Med. 2019 May;44(5):e362-e363. doi: 10.1097/RLU.0000000000002514.

Abstract

Baseline F-FDG PET and MRI were performed in a patient with IgG4-related hypophysitis, showing a 15-mm hypervascular hypermetabolic lesion with sellar and suprasellar extension. Lack of response after 10 months of first-line corticosteroid therapy was demonstrated on both F-FDG PET and MRI. Three months later, after 2 injections of 1 g of rituximab associated with continued corticosteroid therapy, MRI showed substantial shrinkage of the pituitary lesion with minimal residual Gd enhancement, whereas F-FDG PET evidenced complete metabolic response. As such, joint F-FDG PET and MRI assessment during therapy may have a potential interest for treatment response evaluation in pituitary IgG4-related disease.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Autoimmune Hypophysitis / diagnostic imaging*
  • Autoimmune Hypophysitis / drug therapy
  • Fluorodeoxyglucose F18
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Positron-Emission Tomography*
  • Radiopharmaceuticals
  • Rituximab / therapeutic use

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18
  • Rituximab