An Elderly Patient with Sarcoidosis Manifesting Panhypopituitarism with Central Diabetes Insipidus

Endocrine Journal

Tetsuki AMANO¹  Tomoko MIYOSHI²  Toshio OGURA²  Masaya TAKEDA²  Hirofumi MAKINO²  Ken ICHIKI¹  Kenichi INAGAKI²  Fumio OTSUKA²  Hiroyuki OTANI² 

[1] Aioi City Hospital;Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

关键词: Central diabetes insipidus;    Hypophysitis;    Lymphocytic infundibuloneurohypophysitis;    Neurosarcoidosis;    Panhypopituitarism;    Sarcoidosis;   

DOI  :  10.1507/endocrj.K06-161

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(26)Cited-By(4)We here report a 77-year-old Japanese male who suffered general fatigue with progressive thirst and polyuria. Central diabetes insipidus was diagnosed by depletion of vasopressin secretion in response to increases in serum osmolality. Secretory responses of anterior pituitary hormones including adrenocorticotropin, thyrotropin, gonadotropins and growth hormone were severely impaired. Diffuse swelling of the infundibulum as well as lack of T1-hyperintense signal in the posterior lobe was noted by pituitary magnetic resonance imaging. The presence of bilateral hilar lymphadenopathy and increased CD4/CD8 ratio in bronchoalveolar lavage fluid was diagnostic for lung sarcoidosis. Physiological doses of corticosteroid and thyroid hormone were administered in addition to desmopressin supplementation. Complete regression of the neurohypophysial swelling was notable two years after corticosteroid replacement. Diffuse damage of anterior pituitary combined with hypothalamic involvement leading to central diabetes insipidus is a rare manifestation in such elderly patients with neurosarcoidosis.

【 授权许可】

Unknown