Journal List > J Korean Endocr Soc > v.23(2) > 1003427

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Lee, Park, Hwang, Choi, Lee, Kim, Kim, Lee, Son, Kang, and Yoo: A Case of Lymphocytic Infundibuloneurohypophysitis Along with Central Diabetes Insipidus, and this Improved with Conservative Care
Case Report
Journal of Korean Endocrine Society

Journal of Korean Endocrine Society 2008; 23(2): 142-147.

Published online: 20 April 2008

DOI: https://doi.org/10.3803/jkes.2008.23.2.142

A Case of Lymphocytic Infundibuloneurohypophysitis Along with Central Diabetes Insipidus, and this Improved with Conservative Care

Ji-Myoung Lee, Sang-Mi Park, Byung-Hee Hwang, Hyun-Sook Choi, Seong-Su Lee, Jee-Young Kim1, Sung-Rae Kim, Kwang-Woo Lee, Ho-Young Son, Sung-Koo Kang, Soon-Jib Yoo

Department of Endocrinology and Metabolism, The Catholic University of Korea College of Medicine, Korea.

1Department of Radiology, The Catholic University of Korea College of Medicine, Korea.

Received 16 January 2008       Accepted 5 April 2008

Copyright © 2008 Korean Endocrine Society

Abstract

Idiopathic central diabetes insipidus is most likely to occur in young patients who have a clinical history of autoimmune disease. The presentation of clinical findings such as central diabetes insipidus and pituitary stalk thickening on sellar magnetic resonance imaging (MRI) in a young women would strongly suggest lymphocytic hypophysitis, which is a rare inflammatory process involving the pituitary stalk and the pituitary gland, yet this disease can sometimes regress.
We describe here a young woman with lymphocytic hypophysitis. She suffered from an abrupt onset of central diabetes insipidus. Sellar MRI showed thickening of pituitary stalk and loss of high signal of normal neurohypophysis on T1-weighted image. Combind pituitary stimuation test showed a blunted response of GH.
To avoid the potential detrimental complications of invasive diagnostic procedures for testing the pituitary function in a fertile unmarried young woman, we chose close clinical and radiologic follow-up in the proper clinical context. The requirement for DDAVP was slightly decreased over time and the MR imaging obtained serially for 6 months revealed spontaneous partial regression of the pituitary lesion.

Keywords: idiopathic central diabetes insipidus, lymphocytic hypophysitis, young fertile women

Figures and Tables

Fig. 1
Sellar MRI at admission. The normal posterior 'bright spot' on T1 weighted image is lost and pituitary gland is enlarged. Pituitary stalk is thickened with marked contrast enhancement.
jkes-23-142-g001
Fig. 2
Sellar MRI after 45 days later. Previous Pituitary enlargement and Pituitary Stalk thickening was regressed 6.6 mm to 4.6 mm.
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Fig. 3
Sellar MRI after 6 months later. Previous Pituitary enlargement and Pituitary Stalk thickening was more regressed 4.6 mm to 4.29 mm.
jkes-23-142-g003
Table 1
The results of water deprivation and vasopressin challenge test
jkes-23-142-i001
Table 2
The results of combined pituitary stimulation test
jkes-23-142-i002

ACTH, adrenocorticotropic hormone; FSH, follicle stimulating hormone; GH, growth hormone; LH, luteinizing hormone; TSH, thyroid stimulating hormone.

Table 3
Combined pituitary stimulation test after 6 months later
jkes-23-142-i003

Using the same abbreviations on table 2.

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