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HomeArticlesVol 31,2021 No.3Detail

Report of 2 cases of diabetes insipidus and pituitary stalk thickening

Published on May. 18, 2021Total Views: 9434 timesTotal Downloads: 3243 timesDownloadMobile

Author: Yuan WU 1 Chu-Qi GAO 1 Xiao-Qun MA 4 Juan WEN 2 Li CUI 3 Ben-Zhang ZHU 1 Xiao-Yan WU 1 Yi WANG 1

Affiliation: 1. Department of Endocrinology, the first Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China 2. Department of Internal Medicine, Xunyang County Hospital, Ankang 725700, Shaanxi Province, China 3. Department of Endocrinology, Gansu Jiugang Hospital, Jiayuguan 735100, Gansu Province, China 4. Department of Endocrinology, Wuzhong City People's Hospital, Wuzhong 750000, Ningxia Province, China

Keywords: Diabetes insipidus Pituitary stalk thickening Langerhans’ cell histiocytosis

DOI: 10.12173/j.issn.1004-5511.202010023

Reference: Wu Y, Gao CQ, Ma XQ, Wen J, Cui L, Zhu BZ, Wu XY, Wang Y. Report of 2 cases of diabetes insipidus and pituitary stalk thickening[J]. Yixue Xinzhi Zazhi, 2021, 31(3): 231-236. DOI: 10.12173/j.issn.1004-5511.202010023.[Article in Chinese]

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Abstract

To analyze the clinical data of 2 patients with diabetes insipidus (DI) who had pituitary stalk thickening (PST) and review the literature. The 2 patients were a 16-year-old boy and a 13-year-old girl who presented with complaints of thirst and polyuria. Both pituitary MRIs suggested PST. The boy had central diabetes insipidus (CDI), while the girl had both CDI and anterior pituitary dysfunction (APD). Langerhans’ cell histiocytosis (LCH) and germinoma were diagnosed pathologically by pituitary stalk biopsy. PST is one of the most common clinical imaging manifestation in CDI patients suggesting inflammatory or neoplastic infiltration. The differential diagnosis of PST-related diseases is important in clinical practice with pituitary biopsy being the gold standard for diagnosis.

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References

1.  Chapman PR, Singhal A, Gaddamanugu S, et al. Neuroimaging of the pituitary gland: practical anatomy and pathology[J]. Radiol Clin North Am, 2020, 58(6): 1115-1133. DOI: 10.1016/j.rcl.2020.07.009.

2.  王守森, 张发惠, 章翔，等. 垂体柄的显微解剖及其临床意义[J]. 解剖学杂志, 2002, 25(1): 61-63. DOI: 10.3969/j.issn.1001-1633.2002.01.014. [Wang SS, Zhang FH, Zhang X, et al. Microanatomy and clinical significance of pituitary stalk[J]. Chinese Journal of Anatomy, 2002, 25(1): 61-63.]

3.  Maghnie M, Cosi G, Genovese E, et al. Central diabetes insipidus in children and young adults[J]. N Engl J Med, 2000, 343(14): 998-1007. DOI: 10.1056/NEJM2000100 53431403.

4.  顾锋, 金自孟, 张殿喜, 等. 中枢性尿崩症408例的病因及临床特点分析[J]. 中华医学杂志, 2001, 81(19): 17-22. DOI: 10.3760/j:issn:0376-2491.2001.19.004. [Gu F, Jin ZM, Zhang DX, et al. Analysis of the etiology and clinical characteristics of 408 cases of central diabetes insipidus[J]. Chinese Medical Journal, 2001, 81(19): 17-22.]

5.  Hamilton BE, Salzman KL, Osborn AG. Anatomic and pathologic spectrum of pituitary infundibulum lesions[J]. AJR Am J Roentgenol, 2007, 188(3): W223-232. DOI: 10. 2214/AJR.05.2027. 

6.  Grois N, Pötschger U, Prosch H, et al. Risk factors for diabetes insipidus in langerhans cell histiocytosis[J]. Pediatr Blood Cancer, 2006, 46(2): 228-233. DOI: 10. 1002/pbc.20425. 

7.  Girschikofsky M, Arico M, Castillo D, et al. Management of adult patients with Langerhans cell histio-cytosis: recommendations from an expert panel on behalf of Euro-Histio-Net[J]. Orphanet J Rare Dis, 2013, 8: 72. DOI: 10.1186/1750-1172-8-72.

8.  许霞, 聂秀, 熊文, 等. 160例成人朗格汉斯细胞组织细胞增生症患者临床特征分析[J]. 中华血液学杂志, 2015, 36(2): 135-139. DOI: 10.3760/cma.j.issn.0253-2727.2015.02.011. [Xu X, Nie X, Xiong W, et al. A clinicopatho-logical analysis of 160 cases of adult Langerhans cell histiocytosis[J]. Chinese Journal of Hematology, 2015, 36(2): 135-139.]

9.  Islinger RB, Kuklo TR, Owens BD, et al. Langerhans' cell histiocytosis in patients older than 21 years[J]. Clin Orthop Relat Res, 2000, (379): 231-235. DOI: 10.1097/ 00003086-200010000-00027. 

10. Fahrner B, Prosch H, Minkov M, et al. Long-term outcome of hypothalamic pituitary tumors in Lang-erhans cell histiocytosis[J]. Pediatr Blood Cancer, 2012, 58(4): 606-610. DOI: 10.1002/pbc.24042.

11. Jo VY, Fletcher CD. WHO classification of soft tissue tumours: an update based on the 2013 (4th) edi-tion[J]. Pathology, 2014, 46(2): 95-104. DOI: 10.1097/PAT.0000 000000000050. 

12. Kaltsas GA, Powles TB, Evanson J, et al. Hypothalamo-pituitary abnormalities in adult patients with langerhans cell histiocytosis: clinical, endocrinological, and radiological features and response to treatment[J]. Clin Endocrinol Metab, 2000, 85(4): 1370-1376. DOI: 10.1210/jcem. 85.4.6501.

13. García Gallo MS, Martínez MP, Abalovich MS, et al. Endocrine manifestations of Langerhans cell histio-cytosis diagnosed in adults[J]. Pituitary, 2010, 13(4): 298-303. DOI: 10.1007/s11102-010-0233-8.

14. Ling SY, Zhao ZY, Tao B, et al. Pituitary stalk thickening in a large cohort: toward more accurate pre-dictors of pituitary dysfunction and etiology[J]. Endocr Pract, 2019, 25(6): 534-544. DOI: 10.4158/EP-2018-0550.

15. Liu W, Wang L, Liu M, et al. Pituitary morphology and function in 43 children with central diabetes in-sipidus[J]. Int J Endocrinol, 2016, 2016:6365830. DOI: 10.1155/2016/6365830.

16. Echevarría ME, Fangusaro J, Goldman S. Pediatric central nervous system germ cell tumors: a review[J]. Oncologist, 2008, 13(6): 690-699. DOI: 10.1634/theon cologist.2008-0037.

17. Hoffman HJ, Otsubo H, Hendrick EB, et al. Intracranial germ-cell tumors in children[J]. Journal of neu-rosurgery, 1991, 74(4): 545-551. DOI: 10.3171/jns.1991.74.4.0545. 

18. Liang L, Korogi Y, Sugahara T, et al. MRI of intracranial germ-cell tumours[J]. Neuroradiology, 2002, 44(5): 382-388. DOI: 10.1007/s00234-001-0752-0.

19. 李悦. 淋巴细胞性垂体炎11例临床分析及文献学习[D]. 浙江: 浙江大学, 2016. [Li Y. Clinical analysis and litera-ture study of 11 cases of lymphocytic hypophysitis[D]. Zhejiang: Zhejiang University, 2016.]

20. Max MB, Deck MD, Rottenberg DA. Pituitary metastasis: incidence in cancer patients and clinical dif-ferentiation from pituitary adenoma[J]. Neurology, 1981, 31(8): 998-1002. DOI: 10.1212/wnl.31.8.998.

21. 王诺金, 张楠, 邓大同, 等. 以尿崩症为首发表现的垂体转移性肿瘤临床特征分析[J]. 中国全科医学, 2018, 21(18): 2231-2238. DOI: 10.3969/j.issn.1007- 9572.2018.00.026. [Wang NJ, Zhang N, Deng DT, et al. Clinical characteristics of pituitary metastasis with diabetes insipidus as the initial manifestation[J]. Chinese General Practice, 2018, 21(18): 2231-2238.]

22. Turcu AF, Erickson BJ, Lin E, et al. Pituitary stalk lesions: the mayo clinic experience[J]. J Clin Endocrinol Metab, 2013, 98(5): 1812-1818. DOI: 10.1210/jc.2012-4171.

23. Robison NJ, Prabhu SP, Sun P, et al. Predictors of neoplastic disease in children with isolated pituitary stalk thickening[J]. Pediatr Blood Cancer, 2013, 60(10): 1630-1635. DOI: 10.1002/pbc.24577.

24. Sbardella E, Joseph RN, Jafar-Mohammadi B, et al. Pituitary stalk thickening: the role of an innovative MRI imaging analysis which may assist in determining clinical management[J]. Eur J Endocrinol, 2016, 175(4): 255-263. DOI: 10.1530/EJE-16-0455.

25. Wang S, Wang L, Yao Y, et al. Primary lymphocytic hypophysitis: clinical characteristics and treatment of 50 cases in a single centre in China over 18 years[J]. Clin Endocrinol (Oxf), 2017, 87(2): 177-184. DOI: 10.1111/cen.13354.

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