Polyangiitis granulomatosa syndrome in hypogonadothropic hypogonadism patient
Fatih Genç, Ali Gürel, Özlem Üçer
Introduction: Approximately two-thirds of pituitary adenomas secrete excess hormones. The increase in prolactin level suppresses the hypothalamic-pituitary-gonadal axis and can cause osteoporosis and infertility. Polyangiitis granulomatosis is a systemic disease with small vessel vasculitis. Anti-neutrophil cytoplasmic antibodies (ANCA) and especially anti-proteinase 3 (PR3) ANCA are thought to be associated with polyangiitis granulomatosis. Case: A 41-year-old male patient had an 8x5 mm adenoma in the previous pituitary MR imaging. The patient with the diagnosis of proclactinoma and hypogonadotropic hypogonadism applied to our outpatient clinic with complaints of nausea, vomiting and joint pain. On further investigations, acute renal failure and microscopic hematuria and positive C-ANCA were detected and treatment was started immediately. Glucocorticoid and cyclophosphamide treatment was used as the treatment protocol. The patient had previously received hormone replacement therapy due to infertility due to hypogonadotropic hypogonadism caused by pituitary adenoma. Discussion: Polyangiitis granulomatosis is a vasculitis that can have a mortal course, and rapid diagnosis and initiation of treatment significantly reduces the mortality rate. In our case, he was additionally diagnosed with prolactinoma. By carrying these two conditions, it is a rare condition.