title: A patient with diabetes insipidus, anterior hypopituitarism and pituitary stalk thickening.
abstract: BACKGROUND
  A 42-year-old woman presented to the neuroendocrine unit of a hospital with recent-onset polydipsia, polyuria and oligomenorrhea. She had no visual symptoms, head injury or history of malignancy.
  
  
  METHODS
  Measurement of serum sodium and osmolality (as well as urine osmolality) after water deprivation, both before and after desmopressin administration. Measurement of basal serum concentrations of pituitary hormones, insulin-like growth factor 1 and thyroid hormone, cosyntropin stimulation testing of adrenal function, and growth-hormone-releasing hormone-arginine stimulation testing. MRI of the pituitary, CT of the chest and abdomen, skeletal surveys, analyses of cerebrospinal fluid, serology and histologic examination of an excised, painful submandibular salivary gland.
  
  
  METHODS
  Central diabetes insipidus and anterior hypopituitarism secondary to Langerhans cell histiocytosis.
  
  
  RESULTS
  Replacement therapies, including desmopressin, levothyroxine, cyclic estrogen with medroxyprogesterone, and growth hormone. The stalk lesion remained stable after 7 years without specific therapy.
authors.affiliation: Neuroendocrine Unit, Massachusetts General Hospital, Zero Emerson Place, Boston, MA 02114, USA. ntritos@partners.org
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Tritos
authors.forename: Thomas N
authors.initials: TN
authors.lastname: Byrne
authors.forename: Chin-Lee
authors.initials: CL
authors.lastname: Wu
authors.forename: Anne
authors.initials: A
authors.lastname: Klibanski
mesh_terms: D000328:Adult; D003919:Diabetes Insipidus / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007018:Hypopituitarism / Q000175:diagnosis*; D010902:Pituitary Gland / Q000473:pathology*; D010903:Pituitary Gland, Anterior / Q000473:pathology*