Abstract

CONTRERAS-PERUSQUIA, Yuri; OLIVARES-SCHIETEKAT, Sebastián; CORDOBA-OSTOS, Emanuel  and  AHUMADA-AYALA, Miguel. Central diabetes insipidus due to Langerhans cell histiocytosis. Med. interna Méx. [online]. 2019, vol.35, n.4, pp.638-645.  Epub Mar 26, 2021. ISSN 0186-4866.  https://doi.org/10.24245/mim.v35i4.3054.

Central diabetes insipidus is a disorder produced by total or partial deficiency in the synthesis or secretion of antidiuretic hormone caused by hypothalamic-hypophyseal dysfunction, which results in a polyuric syndrome with severe polydipsia. This disorder may be primary when it is caused by genetic abnormalities, or secondary to postoperative, traumatic, infectious or tumoral lesions. This paper reports the case of a male patient, admitted at the endocrine clinic at the age of 15 with a severe polyuric syndrome. At the time of diagnosis of diabetes insipidus, a magnetic resonance was performed demonstrating only a sellar arachnoidocele; however, in the follow-up study conducted eight months later, we found a marked thickening of the hypophyseal stalk and an osteolytic lesion on the left parietal bone. The patient was treated by surgical resection of the lytic parietal bone lesion, followed by 12 cycles of chemotherapy. Two years later, we confirmed the diagnosis of hypogonadotropic hypogonadism. Absent lesions at moment of diagnosis do not exclude the possibility of the appearance of classic tumoral lesions on follow-up studies, like in our case in which only the initial aracnoidocele appeared, but few months later a thickening of the hypophyseal stalk and bone metastasis became evident.

Keywords : Central diabetes insipidus; Langerhans cell histiocytosis; Hypogonado tropic hypogonadism.

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