Hypothalamic/pituitary sarcoidosis

A patient is described with combined pulmonary and central nervous system sarcoidosis, including hypothalamic/pituitary involvement. Formal pituitary challenge testing was performed before steroid treatment and again eight months later. Diabetes insipidus, hyperprolactinemia, and anterior pituitary hormone deficiencies were demonstrated and did not improve significantly in response to steroids. Hypothalamic/pituitary involvement is a rare complication of sarcoidosis, the incidence of which may be under-reported.