Diabetes insipidus
Diabetes insipidus • Hypophysitis - IgG4-related - Ganzer Fall bei Radiopaedia
Diabetes
insipidus • Hypophysitis - IgG4-related - Ganzer Fall bei Radiopaedia
Diabetes insipidus • Infundibuloneurohypophysitis - Ganzer Fall bei Radiopaedia
Diabetes
insipidus • Infundibuloneurohypophysitis - Ganzer Fall bei Radiopaedia
Hypophysitis: Evaluation and Management. Hypophysitis was diagnosed in a 30 year old during the late third trimester of pregnancy. The patient presented with 3 weeks of progression vision loss. Panel a depicts a coronal pre-contrast T1-weighted image of the pituitary. Transsphenoidal biopsy (Panel b) demonstrated lymphocytic hypophysitis and glucocorticoid therapy was begun with prednisone 60 mg daily. Following delivery, the pituitary gland decreased in size (Panel c) and remained stable 2 months (Panel d) and 5 months (Panel e) after glucocorticoid taper and discontinuation
Hypophysitis:
Evaluation and Management. Hypophysitis was diagnosed in a 30 year old during the late third trimester of pregnancy. The patient presented with 3 weeks of progression vision loss. Panel a depicts a coronal pre-contrast T1-weighted image of the pituitary. Transsphenoidal biopsy (Panel b) demonstrated lymphocytic hypophysitis and glucocorticoid therapy was begun with prednisone 60 mg daily. Following delivery, the pituitary gland decreased in size (Panel c) and remained stable 2 months (Panel d) and 5 months (Panel e) after glucocorticoid taper and discontinuation
nicht verwechseln mit: Diabetes mellitus
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siehe auchDiabetes insipidus (DI) is the deficiency or resistance to the hormone vasopressin (antidiuretic hormone), which results in polyuria and polydipsia.
Epidemiology
DI occurs in 3 per 100,000 people .
Pathology
DI may be described as :
- central/neurogenic/hypothalamic: vasopressin deficient (more common)
- peripheral/nephrogenic: vasopressin resistant
Etiology
- central DI: reduced secretion of vasopressin
- trauma
- neurosurgery
- malignancy, e.g. craniopharyngioma, germinoma, metastases
- autoimmune disease, e.g. lymphocytic hypophysitis
- inflammatory disease, e.g. sarcoidosis, Langerhans cell histiocytosis, IgG4-related
- infection, e.g. tuberculosis
- pregnancy
- familial (rare)
- idiopathic
- peripheral DI: increased end-organ resistance to vasopressin
- congenital renal insensitivity to vasopressin (rare)
- long-term lithium use (15% of patients)
- metabolic, e.g. hypokalemia, hypercalcemia
- chronic kidney disease
- pregnancy
Treatment and prognosis
Desmopressin can be used to treat central DI .
Siehe auch:
- Syndrom der inadäquaten ADH-Sekretion (SIADH)
- Bartter-Syndrom
- Diabetes insipidus renalis
- Diabetes insipidus centralis
und weiter:
