[Wegener's granulomatosis causing diabetes insipidus]

Area of Science:

• Rheumatology
• Endocrinology
• Pulmonology

Background:

• Wegener's granulomatosis (WG) is a rare autoimmune vasculitis primarily affecting small to medium-sized vessels.
• Association of WG with diabetes insipidus (DI) is exceptionally uncommon, with limited case reports in medical literature.
• Understanding the spectrum of WG manifestations is crucial for timely diagnosis and management.

Observation:

• A young male patient presented with severe nasal and paranasal sinus histopathological changes consistent with WG.
• Pulmonary involvement, a hallmark of WG, was observed.
• Despite potential hypothalamic involvement in some WG cases, this patient exhibited no signs of hyperprolactinemia or hypothalamic dysfunction on CT scan.

Findings:

• The patient's WG demonstrated typical respiratory and sinus disease.
• Unlike some reported cases, hyperprolactinemia was absent, and hypothalamic imaging was normal.
• Renal and anterior pituitary functions remained unaffected.
• The disease responded favorably to cyclophosphamide treatment.

Implications:

• This case expands the understanding of WG's diverse clinical presentations.
• It underscores the importance of thorough endocrinological and neurological assessment in WG patients.
• The favorable response to cyclophosphamide reinforces its role in managing WG, even in atypical presentations.