A 47 years old gentelman was admitted as a case of DKA. She was kept on insulin infusion protocol despite hydartion her Na remained to be high so she was kept on Na 18% her glucose was controlled but her sodium remained on the higher side so they used clinical disgnosis to start her on miniril tablet twice dialy. MRI pituitary showed thickening of pituitary stalk no adenoma she was discharged on insulin Three doses mix insulin. Her blood tets shows anemia of normochromic normocytic anemia with high ESR, she has ANF positive and thrombocythemia. however she has later well controlled blood sugar, MRI report reported again shows hypophysities. Opinion from rhematology suggested Plaquinel 200 mg bid. After 6 months of tretment ESR reteurn to normal CBC corrected blood sugar was well controlled. Patient can not stop miniriel. 1) What is diagnosis; 2) what is next step of mangemnt regarding miniril and plaquinel; 3) patient refused water Deprivation test.
16 - 18 Apr 2018
Society for Endocrinology