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KMID : 0356620080230020142
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Journal of Korean Society of Endocrinology
2008 Volume.23 No. 2 p.142 ~ p.147
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A Case of Lymphocytic Infundibuloneurohypophysitis Along with Central Diabetes Insipidus, and this Improved with Conservative Care
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Lee Ji-Myoung
Park Sang-Mi
Hwang Byung-Hee
Choi Hyun-Sook
Le Seong-Su
Kim Jee-Young
Kim Sung-Rae
Lee Kwang-Woo
Son Ho-Young
Kang Sung-Koo
Yoo Soon-Jip
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Abstract
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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.
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KEYWORD
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idiopathic central diabetes insipidus, Lymphocytic hypophysitis, young fertile women
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