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[Two cases of lymphocytic infundibuloneurohypophysitis]
Tohru Terao1, Keisuke Taya, Satoshi Sawauchi
1Department of Neurosurgery, Jikei University School of Medicine, Kashiwa Hospital, Japan.
No Shinkei Geka. Neurological Surgery
|December 6, 2003
Summary
Lymphocytic infundibuloneurohypophysitis (LIH) is a rare condition causing diabetes insipidus (DI). Conservative management is recommended for LIH presenting with DI and characteristic MRI findings, as radiological abnormalities often resolve, though DI improvement is less common.
Area of Science:
- Endocrinology
- Neuroimaging
- Immunology
Background:
- Lymphocytic infundibuloneurohypophysitis (LIH) is an inflammatory condition affecting the pituitary gland and stalk.
- It often presents with diabetes insipidus (DI), a condition characterized by excessive thirst and urination.
Observation:
- Two cases of LIH in a 32-year-old male and a 13-year-old male presented with sudden onset DI.
- MRI revealed characteristic findings: loss of posterior pituitary hyperintensity, pituitary stalk swelling, and enlarged pituitary gland with homogeneous enhancement.
- A review of 51 LIH cases (ages 4-74) confirmed DI as the primary symptom and similar MRI findings.
Findings:
- Radiological abnormalities resolved in 56.2% of reviewed LIH cases.
- However, only 13.7% of patients experienced improvement in their diabetes insipidus.
- Conservative management was successful in the two reported cases.
Implications:
- The study suggests that conservative treatment is advisable for suspected LIH with DI and characteristic MRI findings, avoiding surgery unless necessary.
- Early diagnosis and conservative management can lead to resolution of imaging abnormalities.
- Further research may explore more effective treatments to improve DI outcomes in LIH patients.