Isolated diabetes insipidus happened during premenopause solution ten years after
Pathologies of pituitary gland are often revealed by diabetes insipidus. Etiologies are, in first, tumors, inflammatory and granulomatosis diseases after, but stay idiopathic in 24% of French study, 52% of Italian study and 33% of Tunisian study.
Case report: Mrs A., 53 years old, consults in 1998 because polyuriapolydipsia, without diabetes mellitus. She is hospitalized during 2 days and hydric restriction test shows the organic reality. The others neuro-endocrine explorations stay unproductive, without confirmation of appearance of menopause. The brain and hypophysis examination by CT scan is found normal. The MRI shows pituitary stalk thick, but lightly…And, haematologic perturbation, or inflammatory syndrome, or osteo-arthritis pain, or cardiovascular or nephrologic perturbation dont exist, and treatment by MinirinR has permitted to get back stabilized health status. The next MRI controls, executed at 6 and 24 months later, are perfectly stable, and so is clinical status. During 2008, Mrs A., consults because undulant fever and asthenia. Physical examination permits to discover bilateral tibia pain, erythematous lesions on the neck and thorax. Cutaneous biopsy, myelogram and bone biopsy permit to obtain diagnosis of Erdheim Chester syndrome, its to say non Langerhans histiocytosis which aims are cardiovascular system, central and peripherical nervous system and the bone.
The initial having few symptoms situation can explain the time for diagnosis establishment. Nevertheless, in the beginning of the story, it was not justified to propose chemotherapy and supervision stayed justified.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.