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Diabetes insipidus due to hypophysitis

E Weimann1, G Mölenkamp, H J Böhles

  • 1University of Frankfurt, Children's Hospital, Germany.

Hormone Research
|January 1, 1997
PubMed
Summary
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Central diabetes insipidus, a chronic disorder, can be caused by autoimmune hypophysitis. This case highlights that characteristic MRI changes may take up to three years to appear in patients with this condition.

Area of Science:

  • Endocrinology
  • Neuroscience
  • Radiology

Background:

  • Central diabetes insipidus (CDI) is a chronic condition often secondary to identifiable lesions.
  • In a significant portion of CDI cases (20-30%), the etiology remains unclear, with autoimmune processes implicated.
  • This report focuses on a case of CDI in an 18-year-old female.

Observation:

  • The patient presented with decreased vasopressin levels, indicative of CDI.
  • Initial MRI scans at 1.5 years post-manifestation showed no pathological changes and no other endocrine disorders.
  • A follow-up MRI 1.5 years later revealed pituitary stalk thickening, a sign of hypophysitis.

Findings:

  • The patient's vasopressin deficiency was attributed to hypophysitis.
  • The diagnostic MRI findings of hypophysitis were only apparent three years after the initial disease manifestation.

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  • No alternative causes for the vasopressin deficiency were identified.

    • Implications:

    • The delayed appearance of MRI changes in hypophysitis suggests a prolonged diagnostic window.
    • This case underscores the importance of serial imaging in diagnosing autoimmune hypophysitis when initial scans are inconclusive.
    • Understanding the timeline of radiological changes is crucial for timely diagnosis and management of CDI.