An elderly patient with sarcoidosis manifesting panhypopituitarism with central diabetes insipidus

Tomoko Miyoshi, Fumio Otsuka, Masaya Takeda, Kenichi Inagaki, Hiroyuki Otani, Toshio Ogura, Ken Ichiki, Tetsuki Amano, Hirofumi Makino

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

We here report a 77-year-old Japanese male who suffered general fatigue with progressive thirst and polyuria. Central diabetes insipidus was diagnosed by depletion of vasopressin secretion in response to increases in serum osmolality. Secretory responses of anterior pituitary hormones including adrenocorticotropin, thyrotropin, gonadotropins and growth hormone were severely impaired. Diffuse swelling of the infundibulum as well as lack of T1-hyperintense signal in the posterior lobe was noted by pituitary magnetic resonance imaging. The presence of bilateral hilar lymphadenopathy and increased CD4/CD8 ratio in bronchoalveolar lavage fluid was diagnostic for lung sarcoidosis. Physiological doses of corticosteroid and thyroid hormone were administered in addition to desmopressin supplementation. Complete regression of the neurohypophysial swelling was notable two years after corticosteroid replacement. Diffuse damage of anterior pituitary combined with hypothalamic involvement leading to central diabetes insipidus is a rare manifestation in such elderly patients with neurosarcoidosis.

Original languageEnglish
Pages (from-to)425-430
Number of pages6
JournalEndocrine Journal
Volume54
Issue number3
DOIs
Publication statusPublished - 2007

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Neurogenic Diabetes Insipidus
Sarcoidosis
Adrenal Cortex Hormones
Anterior Pituitary Hormones
Thirst
Polyuria
Deamino Arginine Vasopressin
CD4-CD8 Ratio
Bronchoalveolar Lavage Fluid
Pituitary Gland
Thyrotropin
Vasopressins
Gonadotropins
Thyroid Hormones
Adrenocorticotropic Hormone
Osmolar Concentration
Growth Hormone
Fatigue
Magnetic Resonance Imaging
Lung

Keywords

  • Central diabetes insipidus
  • Hypophysitis
  • Lymphocytic infundibuloneurohypophysitis
  • Neurosarcoidosis
  • Panhypopituitarism
  • Sarcoidosis

ASJC Scopus subject areas

  • Endocrinology

Cite this

An elderly patient with sarcoidosis manifesting panhypopituitarism with central diabetes insipidus. / Miyoshi, Tomoko; Otsuka, Fumio; Takeda, Masaya; Inagaki, Kenichi; Otani, Hiroyuki; Ogura, Toshio; Ichiki, Ken; Amano, Tetsuki; Makino, Hirofumi.

In: Endocrine Journal, Vol. 54, No. 3, 2007, p. 425-430.

Research output: Contribution to journalArticle

Miyoshi, Tomoko ; Otsuka, Fumio ; Takeda, Masaya ; Inagaki, Kenichi ; Otani, Hiroyuki ; Ogura, Toshio ; Ichiki, Ken ; Amano, Tetsuki ; Makino, Hirofumi. / An elderly patient with sarcoidosis manifesting panhypopituitarism with central diabetes insipidus. In: Endocrine Journal. 2007 ; Vol. 54, No. 3. pp. 425-430.
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