[Case of central neurosarcoidosis with panhypopituitalism].
A 63-year-old man was admitted because of dizziness, polydipsia, polyuria, and diminished libido. His brain MRI showed swelling of the pituitary gland. Because of panhypopituitarism suggested by hormonal examination, hydrocortisone, desmopressin and levothyroxine sodium were started as hormone replacement therapy. He was given a clinical diagnosis of central neurosarcoidosis with panhypopituitarism because of the presence of an abnormal lung shadow, positive gallium scintigram in bilateral hilar lymph nodes, negative tuberculin skin test, lymphocytosis and a high CD4/8 ratio in bronchoalveolar lavage fluid. After prednisolone therapy, his lung shadow and pituitary swelling reduced significantly. Anti-diuretic hormones and anterior pituitary hormones tended to increase, and his urine volume also decreased. This case suggested that endocrinological abnormalities in central neurosarcoidosis might be improved by prednisolone therapy even if the initiation of treatment is delayed.
Shimaoka
Yuichi
Y
Division of Respiratory Medicine, Niigata University.
Tajima
Shunji
S
Koshio
Nao
N
Fujimori
Fumio
F
Tsubata
Chikako
C
Koya
Toshiyuki
T
Moriyama
Hiroshi
H
Terada
Masaki
M
Takada
Toshinori
T
Gejyo
Fumitake
F
Hasegawa
Takashi
T
Suzuki
Eiichi
E
D002493:Central Nervous System Diseases / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D003919:Diabetes Insipidus / Q000188:drug therapy / Q000209:etiology; D020249:Hormone Replacement Therapy; D006801:Humans; D007018:Hypopituitarism / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage; D012507:Sarcoidosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D016896:Treatment Outcome
D011239:Prednisolone