PRIMARY HYPOTHYROIDISM, CENTRAL DIABETES-INSIPIDUS AND GROWTH-HORMONEDEFICIENCY IN MULTISYSTEM LANGERHANS CELL HISTIOCYTOSIS - A CASE-REPORT

We report on a girl with central diabetes insipidus, growth hormone de ficiency and bone lesions in multisystem Langerhans cell histiocytosis . Thickening of the pituitary stalk was detected by magnetic resonance imaging, which progressed over the course of the disease. During the observation period she developed primary hypothyroidism, which might b e due to the extremely rare involvement of the thyroid gland in this d isease. The girl underwent chemotherapy, which led to a regression of the Langerhans cell histiocytosis-lesion, but the hormone deficiencies persisted and substitution had to be continued. Langerhans cell histi ocytosis should be included in the differential diagnosis in cases wit h pituitary stalk thickening and additional hypothalamic/pituitary hor mone deficiencies, and in cases of acquired primary hypothyroidism, wi th or without enlargement of the thyroid gland and ultrasound findings similar to thyroiditis.