Endocrine Abstracts

Introduction: CID in children is a rare pathology, the diagnosis is generally easy as it manifestes itself by a polyuro_polydipsic syndrome (PPS) of variable severity secondary to an ADH deficiency. The discovery of a thick pituitary stalk in this context must encourage us to look for the etiology with the fear of tumoral causes

Observation: We report the case of a young patient, of 16 years old, with no particular history, hospitalised for sudden polyuroplydipsic syndrome with no precipitating factors. The clinical examination was normal except for a low BMI of 15 kglm² and delayed puberty classified G1P2 TANNER.PPS was about 2,3 liters Biological investigation showed a low urinary density < 1005 and Urinary osmolality of 65 mosm/l. Plasmatic osmolarity was about 298 mosmo/l Anterior pituitary investigation after Desmopressine supplementation showed corticotropin deficiency (cortisol: 117,9 nmol/l, ACTH: 5 pg/ml), the othor anterior pituitary functions were normals Pituitary MIR showed a thick pituitary stalk corresponding to a likely infundibulo-neurohypophysitis after eliminating tumoral, infiltrative and infectious pathologies. The patient was put on replacement therapy (DESMOPRESSINE) and underwent clinical and morphological monitoring every 3 to 6 months.

Conclusion: It is advisable to repeat the etiological investigation several years after the so-called idiopathic forms of CID in search of a tumoral or infiltrative pathology, but also to evaluate the progress of the thickening stalk.