Thickened Pituitary Stalk on Magnetic Resonance Imaging in Children with Central Diabetes insipidus

2000 ◽  
Vol 53 (3) ◽  
pp. 61-64 ◽  
Author(s):  
Paul Czernichow ◽  
Catherine Garel ◽  
Juliane Léger
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Diabetes Insipidus ◽  
Central Diabetes Insipidus ◽  
Pituitary Stalk ◽  
Resonance Imaging

scholarly journals Evolution of childhood central diabetes insipidus into panhypopituitarism with a large hypothalamic mass: is 'lymphocytic infundibuloneurohypophysitis' in children a different entity?

1998 ◽  
Vol 139 (6) ◽  
pp. 635-640 ◽  
Author(s):  
M Maghnie ◽  
E Genovese ◽  
MG Sommaruga ◽  
M Arico ◽  
D Locatelli ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Diabetes Insipidus ◽  
Histopathological Examination ◽  
Dynamic Magnetic Resonance Imaging ◽  
Central Diabetes Insipidus ◽  
Pituitary Stalk ◽  
Hormone Deficiency ◽  
Resonance Imaging ◽  
Dynamic Magnetic Resonance

We report on a 15-year-old girl who had presented with acute onset central diabetes insipidus at the age of 8 years; this was followed by growth failure due to acquired growth hormone deficiency. Initial magnetic resonance imaging showed a uniformly enlarged pituitary stalk and absence of posterior pituitary hyperintensity. Frequent patient examination and magnetic resonance imaging gave unchanged results until after 5 years a large hypothalamic mass and panhypopituitarism were found. Dynamic magnetic resonance imaging documented hypothalamic-pituitary vasculopathy. Histopathological examination revealed perivascular inflammatory lymphoplasmic infiltrates with no granulomatosis or necrosis and negative staining for S-100 protein, suggesting autoimmune inflammatory disease (lymphocytic infundibuloneurohypophysitis?). The response to glucocorticoid pulses (30 mg/kg per day for 3 days i.v.) was favorable. the hypothalamic mass being halved and partial anterior pituitary function recovery maintained for 2 years after the start of treatment. We suggest that long-term surveillance is needed for isolated and chronic thickening of the pituitary stalk and that dynamic magnetic resonance imaging can contribute to the demonstration of hypothalamic-pituitary vascular impairment associated with local vasculitis.

Metastatic Adenocarcinoma Presenting with Central Diabetes Insipidus

1998 ◽  
Vol 84 (1) ◽  
pp. 85-86
Author(s):  
Mark A. Marinella
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Diabetes Insipidus ◽  
Water Deprivation ◽  
Brain Magnetic Resonance Imaging ◽  
Central Diabetes Insipidus ◽  
Metastatic Adenocarcinoma ◽  
Rare Occurrence ◽  
Resonance Imaging ◽  
Recent Onset

The case of a previously healthy 63-year-old female with metastatic adenocarcinoma to the hypothalamus presenting with central diabetes insipidus is presented. The patient was found to have metastatic disease isolated to her hypothalamus on brain magnetic resonance imaging as well as a water deprivation test consistent with central diabetes insipidus. The patient had a decrease in symptoms of polyuria and polydypsia as well as a decrease in urine volumes after treatment with intranasal vasopressin. Even though a rare occurrence, physicians should consider metastatic adenocarcinoma in patients with recent-onset polyuria and polydypsia.

Panhypopituitarism without diabetes insipidus: Magnetic resonance imaging of pituitary stalk transection

1990 ◽  
Vol 149 (4) ◽  
pp. 235-236 ◽  
Author(s):  
C. Christophe ◽  
G. Van Vliet ◽  
G. Dooms ◽  
M. Lemort ◽  
N. Perlmutter ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Diabetes Insipidus ◽  
Pituitary Stalk ◽  
Resonance Imaging

scholarly journals A Longitudinal Study of Vasopressin Cell Antibodies, Posterior Pituitary Function, and Magnetic Resonance Imaging Evaluations in Subclinical Autoimmune Central Diabetes Insipidus

1999 ◽  
Vol 84 (9) ◽  
pp. 3047-3051 ◽  
Author(s):  
A. De Bellis ◽  
A. Colao ◽  
F. Di Salle ◽  
V. I. Muccitelli ◽  
S. Iorio ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Autoimmune Diseases ◽  
Diabetes Insipidus ◽  
Central Diabetes Insipidus ◽  
Pituitary Function ◽  
Study Entry ◽  
Posterior Pituitary ◽  
Resonance Imaging

Cytoplasmic autoantibodies to vasopressin-cells (AVPcAb) have been detected not only in patients with overt central diabetes insipidus (CDI), but also in patients with endocrine autoimmune diseases without CDI. This suggests that complete CDI can be preceded by a preclinical stage. Among 878 patients with endocrine autoimmune diseases without CDI, 9 patients found to be AVPcAb positive and 139 AVPcAb-negative controls were enrolled in this open prospective study. They were evaluated for AVPcAb and posterior pituitary function at least yearly for about 4 yr (range, 37–48 months); during this span, magnetic resonance imaging (MRI) of posterior pituitary and stalk was performed only in the AVPcAb-positive patients. Five of the 9 AVPcAb-positive patients had normal posterior pituitary function at study entry. They were AVPcAb positive throughout the follow-up period. At later stages of the study, 3 of them developed partial CDI, and 1 developed complete CDI. The remaining 4 patients showed impaired response to the water deprivation test at study entry and were diagnosed as having partial CDI. Two of them agreed to receive desmopressin replacement for 1 yr. After this treatment, the patients became negative for AVPcAb and displayed normal posterior pituitary function until the end of the follow-up. Conversely, the 2 untreated patients with partial CDI remained AVPcAb positive. One of them developed overt CDI. None of the controls became AVPcAb positive or developed CDI. The normal hyperintense MRI signal of the posterior pituitary, present at study entry, persisted subsequently in all 9 AVPcAb-positive patients, including those developing overt CDI, only disappearing in the late phase of complete CDI. In asymptomatic subjects, the monitoring of AVPcAb, but not MRI, seems to be useful to predict a progression toward partial/overt CDI. Early desmopressin therapy in patients with partial CDI could interrupt or delay the autoimmune damage and the progression toward clinically overt CDI.

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