LYMPHOCYTIC HYPOPHYSITIS PRESENTING WITH DIABETES-INSIPIDUS - CASE-REPORT AND LITERATURE-REVIEW

Lymphocytic adenohypophysitis is an autoimmune disorder of the anterio r pituitary gland which usually occurs in a woman in the postpartum pe riod. It has been considered that lymphocytic hypophysitis is confined to the adenohypophysis sparing the neurohypophysis, and that diabetes insipidus is not a clinical feature of the disorder. Here we report t he case of a 50-year-old woman with lymphocytic hypophysitis which pre sented with diabetes insipidus. MRI indicated homogenous swelling of t he whole pituitary gland, loss of the normal high intensity of the pos terior pituitary, and thickening of the pituitary stalk. A biopsied sp ecimen of the pituitary revealed diffuse lymphocytic infiltration. The diabetes insipidus was controlled by the administration of DDAVP. The anterior pituitary function was not greatly damaged, and no hormonal replacement therapy was necessary. We suggest that this case represent s a variant of lymphocytic adenohypophysitis and/or lymphocytic infund ibuloneurohypophysitis, in which the chronic inflammatory process invo lves the infundibulum, adenohypophysis and neurohypophysis.