Lymphocytic hypophysitis with a long latent period from onset of central diabetes insipidus to development of pituitary enlargement.
A 61-year-old man presented with central lymphocytic hypophysitis. Initial pituitary MRI imaging was normal, except for loss of the "bright spot" of the posterior lobe. A diagnosis of idiopathic diabetes insipidus was made. Two years later, pituitary gland enlargement with panhypopituitarism was detected. Eight months after commencing a replacement dose of corticosteroid, the pituitary enlargement was reduced in size. These findings resulted in a diagnosis of lymphocytic hypophysitis. In patients with idiopathic diabetes insipidus, it is important to suspect lymphocytic hypophysitis and to perform a long follow-up to repeat endocrinological examinations and pituitary imaging.
Akahori
Hiroshi
H
Department of Endocrinology and Metabolism, Tonami General Hospital, Toyama. akahori0606@hotmail.com
Sugimoto
Tatsuho
T
D020790:Diabetes Insipidus, Neurogenic / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010900:Pituitary Diseases / Q000175:diagnosis* / Q000209:etiology* / Q000473:pathology; D013997:Time Factors