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

Vauchot, Fabien, MD, PhD*; Bourdon, Aurélie, MD*; Hay, Boramy, MD*; Mariano-Goulart, Denis, MD, PhD*,†; Ben Bouallègue, Fayçal, MD, PhD*,†

doi: 10.1097/RLU.0000000000002514
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Baseline 18F-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 18F-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 18F-FDG PET evidenced complete metabolic response. As such, joint 18F-FDG PET and MRI assessment during therapy may have a potential interest for treatment response evaluation in pituitary IgG4-related disease.

From the *Nuclear Medicine Department, Montpellier University Hospital; and

PhyMedExp, INSERM, CNRS, Montpellier University, Montpellier, France.

Received for publication December 7, 2018; revision accepted January 17, 2019.

Conflicts of interest and sources of funding: none declared.

Correspondence to: Fayçal Ben Bouallègue, MD, PhD, Lapeyronie University Hospital, 371 Av Doyen Giraud, 34090 Montpellier, France. E-mail: faycal.ben-bouallegue@umontpellier.fr.

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