Reversible endocrine dysfunction and pituitary stalk enlargement.
We report 4 patients (3 of which were children) with diabetes insipidus and different degrees of hypopituitarism in whom a pituitary stalk enlargement was disclosed on imaging techniques, and in whom radiological and functional recovery was observed during follow-up. Pituitary substitution therapy with desmopressin, thyroxine, hydrocortisone, growth hormone and/or oral contraceptives was prescribed. During follow-up, regression of the stalk lesion was seen which was spontaneous in 2 cases, following a short course of corticosteroids in another and an empirical trial of tuberculostatic drugs in the fourth. A partial recovery of pituitary function was also observed. These cases illustrate that pituitary stalk enlargement and associated hypopituitarism may be reversible; however, this morphological and functional recovery has rarely been described in adults and has not been previously reported in children.
Chico
A
A
Section of Pediatric Endocrinology and Neurology, Hospital de Cruces, Basque Country University, Bilbao, Spain.
Puig-Domingo
M
M
Martul
P
P
De Juan
M
M
Prats
J M
JM
Mauricio
D
D
Webb
S M
SM
D000293:Adolescent; D002648:Child; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use; D003919:Diabetes Insipidus / Q000150:complications* / Q000188:drug therapy; D005260:Female; D007987:Gonadotropin-Releasing Hormone; D019382:Human Growth Hormone / Q000627:therapeutic use; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007018:Hypopituitarism / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D010902:Pituitary Gland / Q000473:pathology* / Q000503:physiopathology*; D013973:Thyrotropin-Releasing Hormone; D013974:Thyroxine / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
D007004:Hypoglycemic Agents; D019382:Human Growth Hormone; D007987:Gonadotropin-Releasing Hormone; D013973:Thyrotropin-Releasing Hormone; D003894:Deamino Arginine Vasopressin; D013974:Thyroxine; D006854:Hydrocortisone