30 year old with pyderma gangrinosum on chronic cyclosporine, MTX and tapering prednisone admitted for diplopia and found to have bilateral third nerve palsy. MRI read as enlarging pituitary lesion but on my read has hypophysitis and enhancing wall of bilateral cavernous sinus. LP unremarkable and responded to IV solumedrol.
This must somehow be related to the PG but only one short case I could find in literature. Has anyone else ever seen this? And what would be the next step in treatment since obviously broken through on the current regimen.
Thank
Mitch Strominger.
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