Open AccessCentral diabetes insipidus unveiled by glucocorticoid therapy in a patient with an empty sella
Author(s) -
Lu Yang,
Shu Lin,
Qibing Xie,
Geng Yin
Publication year - 2020
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000022939
Subject(s) - medicine , diabetes insipidus , hypopituitarism , glucocorticoid , prednisone , pediatrics , physical examination , diabetes mellitus , empty sella syndrome , magnetic resonance imaging , adrenal insufficiency , surgery , endocrinology , radiology
Rationale: Some diseases contribute to hypopituitarism without clinical manifestations and the glucocorticoid therapy may unveil central diabetes insipidus. The condition is rare and usually causes problems for clinical physicians. Patient concerns: A 59-year-old woman presented to our hospital due to facial numbness and persistent eyelid heaviness. Diagnosis: Physical examination and cerebrospinal fluid examination supported a diagnosis of Guillain–Barré syndrome. Magnetic resonance imaging showed an empty sella. Hormone test indicated hypopituitarism. Interventions: The patient received intravenous immunoglobulin and glucocorticoid. Central diabetes insipidus appeared after 20 days. Subsequently, the patient was prescribed 1-desamino-8-D-arginine vasopressin and prednisone. Outcomes: During 6 months’ follow-up, the patient's urine output was gradually reduced to normal level. Lessons: This case indicated that hypopituitarism may be caused by an empty sella and be masked by adrenal insufficiency. Central diabetes insipidus may present after glucocorticoid therapy.