title: Multifocal fibrosclerosis as a possible cause of panhypopituitarism with central diabetes insipidus.
abstract: Multifocal fibrosclerosis denotes a combination of similar fibrous disorders occurring at different anatomical sites. We encountered a 53-year-old male patient with orbital pseudotumor, chronic paranasal sinusitis, fibrous nodules of the lungs, intracranial pachymeningitis, and panhypopituitarism with central diabetes insipidus (DI) as a possible manifestation of multifocal fibrosclerosis. It has been reported that intracranial pachymeningitis or orbital pseudotumor associated with multifocal fibrosclerosis could invade the sella turcica causing a variety of anterior and/or posterior pituitary dysfunctions. In our case, intracranial pachymeningitis apparently involved the pituitary stalk and gland. Isolated gonadotropin deficiency, in addition to central DI, preceded panhypopituitarism. Although panhypopituitarism with central DI due to multifocal fibrosclerosis is quite rare and only one case has ever been reported, this systemic fibrotic disorder can be a possible cause of panhypopituitarism with central DI.
authors.affiliation: Third Division Department of Medicine, Kobe University School of Medicine, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Kishimoto
authors.forename: Y
authors.initials: Y
authors.lastname: Okimura
authors.forename: K
authors.initials: K
authors.lastname: Kimura
authors.forename: I
authors.initials: I
authors.lastname: Mizuno
authors.forename: G
authors.initials: G
authors.lastname: Iguchi
authors.forename: M
authors.initials: M
authors.lastname: Fumoto
authors.forename: Y
authors.initials: Y
authors.lastname: Takahashi
authors.forename: F
authors.initials: F
authors.lastname: Kanda
authors.forename: H
authors.initials: H
authors.lastname: Kaji
authors.forename: H
authors.initials: H
authors.lastname: Abe
authors.forename: K
authors.initials: K
authors.lastname: Hanioka
authors.forename: K
authors.initials: K
authors.lastname: Chihara
mesh_terms: D003919:Diabetes Insipidus / Q000150:complications*; D005355:Fibrosis; D005640:Follicle Stimulating Hormone / Q000097:blood; D006261:Headache / Q000150:complications; D006801:Humans; D007018:Hypopituitarism / Q000209:etiology*; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008875:Middle Aged; D012598:Sclerosis; D012852:Sinusitis / Q000150:complications
chemical_list: D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone