• 대한수의학회지
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• 제51권4호
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• pp.319-323
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• 2011

A 12-year-old spayed female Yorkshire terrier dog was presented with two-weeks history of lethargy, mental dullness and polydipsia. Neurologic examination revealed proprioceptive defect of all limbs and loss of swallowing gag reflex. The dog revealed persistent dehydration, hypernatremia, hyperosmolarity and hyposthenuria. On magnetic resornance imaging (MRI), the mass were heterogeneous signality on T1 weighted images, hyperintense signality on T2 weighted image with contrast enhancement on hypothalamohypophyseal lesion. Based on these findings, the dog was suspected as having pituitary gland tumor. Through water deprivation test and response to desmopressin acetate (1-deamino-8-D-arginine, DDAVP), this case was diagnosed by central diabetes insipidus (CDI). This paper reports the clinical sign, MRI, response to the exogenous antidiuretic hormone of CDI due to suspected pituitary tumor in a dog and DDAVP administration was evaluated effective therapy to correct hypernatremia induced by CDI.

• Journal of Chest Surgery
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• 제38권12호
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• pp.866-869
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• 2005

랑게르한스 세포 조직구증(Langerhans Cell Histiocytosis)은 병적인 랑게르한스 세포의 과도한 증식과 침윤으로 생기는 병으로 병태 생리가 확실하게 밝혀져 있지 않다. 소아에서 백만명 당 3$\∼$4명의 발생률을 보이나 성인의 경우 그 발생빈도가 확실치 않다. 피부, 귀, 골수, 간, 비장, 폐, 뇌하수체-시상하부, 위장관 등 거의 모든 장기가 침범되며 뇌하수체-시상하부 축이 침범되면 요붕증이 발생한다. 원발성 폐 랑게르한스 세포 조직구증이 타장기의 침범과 동반되는 경우는 드물며, 요붕증을 동반한 경우는 더욱 드물다. 국내에서 랑게르한스 세포 조직구증 중 요붕증을 동반한 예는 다수의 보고가 있었으나 중추신경계 등 폐 이외의 장기침범이었으며 원발성 폐 랑게르한스 세포 조직구증과 동반된 중추성 요붕증은 1예가 보고되었다. 저자는 중추성 요붕증을 동반한 폐 랑게르한스 세포 조직구증을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Korean Neurosurgical Society
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• 제29권6호
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• pp.822-825
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• 2000

Lymphocytic infundibuloneurohypophysitis is a rare inflammatory disorder, which may be caused by autoimmune response, affecting the infundibulum and the posterior lobe of the pituitary gland. The authors present a 15-year-old man with central diabetes insipidus, whose sellar magnetic resonance imaging (MRI) showed a focal thickening of the infundibulum and loss of high signal of the normal neurohypophysis on T1-weighted images. The histopathological diagnosis was lymphocytic infundibuloneurohypophysitis. When a patient presents with central diabetes insipidus and infundibular thickening on brain MRI, this entity should be included in the differential diagnosis though it is very rare. The significance of this entity in treatment is that it is basically not a surgical one, and surgery is needed only for tissue diagnosis. Symptomatic treatment and observation make it regress spontaneously.

• 대한한의학회지
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• 제21권1호
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• pp.99-102
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• 2000

Central diabetes insipidus(CDI) results from deficient vasopressin(antidiuretic hormone) secretion and causes polydipsia and polyuria. Its etiologic diagnosis is confirmed with an increase of urine osmolality by administering desmopressin(DDAVP) after water restriction. Because cm is caused by deficiency of vasopressin, up to now, desmopressin, a synthetic analog of vasopressin, has been the drug of choice in the treatment of CDI. However, under such treatment, CDI patients suffer from the continual administration of DDAVP throughout one's life and high cost of the treatment We administrated oriental herb medicine on a cm patient in a state of discontinuance of DDAVP. Prior to the study, brain sella MRI was scanned to exclude germinoma. In addition, urine analysis, serum and urinary osmolality, daily urinary volume, serum electrolyte levels were measured. Chungsimyunjatang was administered for 15 days, and urine analysis, urine osmolality, daily urinary volume, serum Na were measured several times again during the therapy, As a result, urinary frequency increased, serum Na slightly elevated, but specific gravity of urine, urinary osmolality severely decreased and daily urinary volume substantially increased. However, the frequency of DDAVP treatment was reduced from four times per day to once or twice a day with the continual administration of the Chungsimyunja-tang for two months after the discharge.

• Tuberculosis and Respiratory Diseases
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• 제78권4호
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• pp.463-468
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• 2015

Pulmonary Langerhans cell histiocytosis is an uncommon diffuse cystic lung disease in adults. In rare cases, it can involve extrapulmonary organs and lead to endocrine abnormalities such as central diabetes insipidus. A 42-year-old man presented with polyphagia and polydipsia, as well as a dry cough and dyspnea on exertion. Magnetic resonance imaging of the hypothalamic-pituitary system failed to show the posterior pituitary, which is a typical finding in patients with central diabetes insipidus. This condition was confirmed by a water deprivation test, and the patient was also found to have type 2 diabetes mellitus. Computed tomographic scanning of the lungs revealed multiple, irregularly shaped cystic lesions and small nodules bilaterally, with sparing of the costophrenic angles. Lung biopsy through video-assisted thoracoscopic surgery revealed pulmonary Langerhans cell histiocytosis. On a follow-up visit, only 1 year after the patient had quit smoking, clinical and radiological improvement was significant. Here, we report an uncommon case of pulmonary Langerhans cell histiocytosis that simultaneously presented with diabetes insipidus and diabetes mellitus.

• 대한한방내과학회지
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• 제44권5호
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• pp.979-986
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• 2023

Objective: The purpose of this study is to report the case of intracranial germ cell tumor-induced central diabetes insipidus (CDI) in a child treated with Korean herbal medicine. Methods: A nine-year-old female patient diagnosed with intracranial germ cell tumor-induced CDI suffering from polyuria, polydipsia, and headache was hospitalized. Nocturia frequency and 24-hour urine volume were assessed. Results: The patient was treated with Korean medicine, including Nokyong-hwan. As a result of the 6-day inpatient treatment, nocturia frequency was decreased 3-4 times to 0-1 time, and 24-hour urine volume was decreased. Conclusion: Korean medicine, including Nokyong-hwan, may be considered an optional treatment for releasing the symptoms of intracranial germ cell tumor-induced CDI. Further studies are needed to confirm this finding.

• Tuberculosis and Respiratory Diseases
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• 제57권3호
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• pp.284-288
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• 2004

폐암에서 중추성 요붕증이 병합되는 경우는 드물며, 그 원인은 대개 뇌하수체로의 전이에 의한 것으로, 이런 경우 수술적 치료나 방사선 치료가 도움이 된다. 그러나 부종양성 증후군의 일부로 발현될 수도 있으며, 이 경우에는 데스모프레신으로 효과적으로 치료할 수 있다. 저자들은 갈증, 다음, 다뇨를 주소로 내원한 비소세포폐암 환자에서 수분제한검사로 중추성 요붕증을 확진한 환자를 경험하였기에 이를 보고하는 바이다.

• Journal of Yeungnam Medical Science
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• 제22권2호
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• pp.259-265
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• 2005

Central diabetes insipidus (DI) is a syndrome characterized by thirst, polydipsia and polyuria. Langerhans cell histiocytosis is one of the etiologies of DI. Recently we experienced a central DI associated with Langerhans cell histiocytosis. The 44 years old female patient complained right hip pain, polydipsia and polyuria. We carried out water deprivation test. After vasopressin injection, urine osmotic pressure was increased from 109 mOsmol/kg to 327 mOsmol/kg (300%). Brain MRI showed a thickened pituitary stalk and air bubble like lesions sized with 5cm, 7cm was shown on fifth L-spine and right hip bone at hip bone CT. CT guided biopsy revealed abnormal histiocytes proliferation and abundant lymphocytes. The final diagnosis was central DI associated with systemic Langerhans cell histiocytosis invading hip bone, L-spine and pituitary stalk. Desmopressin and etoposide chemotherapy were performed to the patient.

• 한국동물위생학회지
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• 제45권2호
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• pp.139-143
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• 2022

A 10-year-old, spayed female miniature schnauzer was referred to the Veterinary Medical Teaching Hospital of Chungnam National University due to evaluation of sudden polyuria (PU) and, polydipsia (PD) (540 mL/kg/day) with severe anemia and weight loss. Blood examination results were normal except for severe anemia (hematocrit, [HCT]: 11.8%). Urinalysis revealed a urine specific gravity (USG) of 1.003, whereas urine sediment was not specific. Urine osmolality was 90 mOsm (reference range: 800~2500 mOsm), and plasma osmolality was 303 mOsm. No specific lesions were found using diagnostic imaging including radiography, ultrasonography and magnetic resonance imaging (MRI). The serum cortisol level was normal in cosyntropin stimulation test. Plasma arginine vasopressin (AVP) concentration was <0.4 pg/mL (reference range: 3.49~5.45 pg/mL). Blood transfusion was initiated in addition to an oral prescription of desmopressin acetate (DDAVP, 0.1 mg/head) thrice a day for one week. The patient was rechecked for clinical signs, urine osmolality, and USG; the clinical signs of PU/PD were resolved, urine osmolality increased to 1106 mOsm, and, USG increased to 1.021. Considering the improved clinical signs, and increased urine osmolality, and USG after DDAVP treatment, the dog was diagnosed with central diabetes insipidus. USG and urine osmolality increased to >1.030 and 2200 mOsm, respectively. Anemia also gradually improved and HCT increased to >37%. DDAVP was tapered to 0.1 mg/head twice a day and all clinical signs in the patient have completely resolved.

• Clinical and Experimental Pediatrics
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• 제53권7호
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• pp.759-765
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• 2010

Purpose: This study evaluated the clinical manifestations of and risk factors for pituitary insufficiency in children and adolescents with Rathke's cleft cysts. Methods: Forty-four patients with Rathke's cleft cysts younger than 19 years who visited Seoul National University Children's Hospital between January 1995 and September 2009 were enrolled. Rathke's cleft cysts were confirmed histologically through an operation in 15 patients and by brain magnetic resonance imaging (MRI) in 29 patients. The clinical, hormonal, and imaging features were reviewed retrospectively. Results: The clinical presentation of symptomatic patients was as follows: headache (65%), endocrinopathy (61%), and visual disturbance (19%). Endocrinopathy included central precocious puberty (18%), diabetes insipidus (14%), general weakness (11%), and decreased growth velocity (7%). After surgery, hyperprolactinemia resolved in all patients, but growth hormone insufficiency, hypothyroidism, and diabetes insipidus did not improve. Pituitary insufficiency except gonadotropin abnormality correlated significantly with severe headache, visual disturbance, general weakness, and cystic size. Suprasellar extension of cysts and high signals in the T2-weighted image on brain MRI were related to hypothyroidism, hypocortisolism, and diabetes insipidus. Multivariable linear regression analysis showed that only general weakness was a risk factor for pituitary insufficiency ($R^2$=0.549). Conclusion: General weakness is a risk factor for pituitary insufficiency in patients with Rathke's cleft cysts. When a patient with a Rathke's cleft cyst complains of general weakness, the clinician should evaluate pituitary function and consider surgical treatment.