Spontaneous Remission of Diabetes Insipidus Due to CNS Sarcoidosis

Inaba, Hidefumi; Shigematsu, Satoshi; Kobayashi, Satoshi; Nishio, Shintaro; Hashizume, Kiyoshi

doi:10.2169/internalmedicine.48.1583

Cited by 7 publications

(13 citation statements)

References 8 publications

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“…There have been few case reports that diabetes insipidus could be cured in this situation, except for one spontaneous remission case (11). It has been considered that anterior pituitary function is difficult to restore, because hypopituitarism is not improved although the thickened pituitary stalk and enlarged pituitary gland return to their normal shapes after steroid treatment (3,12).…”

Section: Discussionmentioning

confidence: 99%

Partial Improvement of Anterior Pituitary Deficiency Following Steroid Treatment in a Patient with Neurosarcoidosis Accompanied by Central Diabetes Insipidus

et al. 2012

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A 58-year-old woman was admitted due to visual field abnormalities, thirst, polydipsia, polyuria and fever. T1-weighted magnetic resonance imaging revealed an absence of the usual bright signal in the posterior lobe of the pituitary gland, and an enlarged pituitary gland with a thickened stalk was enhanced by the gadolinium contrast medium. Computed tomography revealed tumor lesions in the left maxillary sinus and right retroperitoneum and axillary and subclavian lymph node swelling. An endocrinological provocation test demonstrated that her pituitary endocrine function was disturbed, although her ACTH and TSH secretion was normal. The patient was histologically diagnosed with neurosarcoidosis accompanied by hypopituitarism and central diabetes insipidus upon an examination of a subclavian lymph node specimen. Six months of prednisolone treatment resulted in the disappearance of any morphological abnormalities in the pituitary gland and stalk as well as a partial improvement in her LH, FSH and GH secretions. Pituitary endocrine functions can be rescued if steroid treatment is performed under conditions that maintain several hormonal axes.

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Section: Discussionmentioning

confidence: 99%

Partial Improvement of Anterior Pituitary Deficiency Following Steroid Treatment in a Patient with Neurosarcoidosis Accompanied by Central Diabetes Insipidus

et al. 2012

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“…Studies show that despite radiological evidence of regression with steroid therapy, return of endocrine function remains unlikely 12 13. There are case reports supporting recovery in patients started on steroid therapy within 1 month of onset of symptoms, although it is difficult to establish whether this is related to rapid institution of treatment or an atypical disease course 14 15. Unfortunately due to the insidious onset of symptoms, most patients have already passed this point at the time of presentation.…”

Section: Discussionmentioning

confidence: 99%

Diabetes insipidus secondary to sarcoidosis presenting with caseating granuloma

Alam

Thomas²

2011

Case Reports

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“…Table I provides a summary and Table II provides a detailed list of the characteristics of the 20 patients who were diagnosed with neurosarcoidosis with CDI. The patients included 12 men [8-12, 14, 15, 17] and eight women [7,10,13,16,18,19], with a mean age of 33 years. The first symptom was polyuria in 13 patients [7][8][9][11][12][13][14][15][16][17] and polydipsia in eight patients [7][8][9][11][12][13][14][15].…”

Section: Study Selectionmentioning

confidence: 99%

“…Isolated neurosarcoidosis was reported in four patients [7,8,10,12]. Brain MRI showed abnormal findings in the pituitary stalk in 10 patients [7,8,[10][11][12][13]16], abnormal findings in the pituitary gland in nine patients [8][9][10][11][12][13]15], and loss of high intensity of the posterior lobe of the pituitary in nine patients [8,9,[11][12][13]. Twelve patients were diagnosed through biopsies of the lymph nodes [8,10,14,16,17], lungs [8][9][10], and skin [13,15], while only one patient underwent a brain biopsy [8].…”

Section: Study Selectionmentioning

confidence: 99%

“…Steroid therapy was administered to 17 patients [8][9][10][11][12][14][15][16][17][18][19], infliximab was administered to two patients [17,19], cyclophosphamide was administered to one patient [10], and methotrexate was administered to one patient [19]. Desmopressin (1-desamino-8-D-arginine vasopressin) (DDAVP) was used to treat the symptoms of CDI in 19 patients [7][8][9][10][11][12][13][14][16][17][18][19]. Fourteen patients showed improvement in their abnormal brain MRI findings [8][9][10][11][12][13][15][16][17], but no patients showed improvement in the loss of high signal intensity in the posterior lobe of the pituitary.…”

Section: Study Selectionmentioning

confidence: 99%

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Magnetic resonance imaging and symptoms in patients with neurosarcoidosis and central diabetes insipidus

Kakehi¹,

Adachi²,

Fukuyasu³

et al. 2019

Endokrynologia Polska

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Introduction: In the clinical setting, the diagnosis of neurosarcoidosis in patients with central diabetes insipidus (CDI) is typically based both on symptoms (i.e. polydipsia or polyuria) and brain magnetic resonance imaging (MRI) findings (e.g. pituitary abnormality). However, inconsistent changes in the patient's symptoms and brain MRI findings may occur during the clinical course of the disease. This review was performed to summarise the relationship between symptoms and brain MRI findings in previously reported cases of neurosarcoidosis with CDI. Material and methods: Case studies of patients diagnosed with neurosarcoidosis with CDI were collected via a PubMed search of studies published through 30 June 2018. Results: Thirteen eligible studies were reviewed (20 patients; 12 men, 8 women; mean age 33 years). Polydipsia or polyuria was the first symptom in 13 patients. The mean duration from disease onset to diagnosis was 3.4 months. Brain MRIs showed abnormal findings in the hypothalamus and pituitary for 17 patients. Immunosuppressive drugs were used in 17 patients. For 14 patients, MRI findings improved, while symptoms did not. Conclusion: Patients with both neurosarcoidosis and CDI symptoms often do not improve, despite the fact that brain MRI findings often improve following treatment. More studies involving detailed pathological analyses and longer follow-up periods are necessary.

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Spontaneous Remission of Diabetes Insipidus Due to CNS Sarcoidosis

Abstract: Central nervous system (CNS)

Cited by 7 publications

References 8 publications

Partial Improvement of Anterior Pituitary Deficiency Following Steroid Treatment in a Patient with Neurosarcoidosis Accompanied by Central Diabetes Insipidus

Partial Improvement of Anterior Pituitary Deficiency Following Steroid Treatment in a Patient with Neurosarcoidosis Accompanied by Central Diabetes Insipidus

Diabetes insipidus secondary to sarcoidosis presenting with caseating granuloma

Magnetic resonance imaging and symptoms in patients with neurosarcoidosis and central diabetes insipidus

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