H. Koshiyama et al., LYMPHOCYTIC HYPOPHYSITIS PRESENTING WITH DIABETES-INSIPIDUS - CASE-REPORT AND LITERATURE-REVIEW, Endocrine journal, 41(1), 1994, pp. 93-97
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.