Lymphocytic infundibuloneurohypophysitis presenting with central diabetes insipidus: a case report and review of previous Korean cases / 대한내과학회지

ABSTRACT

Lymphocytic infundibuloneurohypophysitis is a neuroendocrine disorder characterized by autoimmune inflammation of the pituitary stalk and neurohypophysis. Clinical findings such as acute onset central diabetes insipidus and the regression of characteristic magnetic resonance imaging (MRI) findings allow for the possible diagnosis of this disease. Three cases of lymphocytic infundibuloneurohypophysitis have been previously reported in Korea. Here we report a case in a 66-year-old woman, along with a review of previously reported occurrences in Korea. A woman presented with abrupt-onset central diabetes insipidus. Sella MRI showed thickening of the pituitary stalk and loss of high T1 signals that are associated with a normal neurohypophysis. Basal pituitary hormone levels were normal with the exception of growth hormone, which was low. The patient refused transsphenoidal pituitary biopsy and we thus chose to continue close clinical and radiologic follow-up after desmopressin nasal spray application. The need for desmopressin decreased slightly over time and MRI obtained after 6 months showed regression of the pituitary stalk lesion.