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1型糖尿病并发尿崩症:垂体脓肿的诊断

Diabetes Insipidus Complicating Diabetes Mellitus Type 1: A Pituitary Abscess Diagnosis.

作者信息

Lionetti Barbara, Minuto Nicola, Bassi Marta, Napoli Flavia

机构信息

Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132, Genoa, Italy.

Pediatric Clinic and Endocrinology Unit, IRCCS Istituto Giannina Gaslini, 16147, Genoa, Italy.

出版信息

JCEM Case Rep. 2024 Jun 3;2(6):luae057. doi: 10.1210/jcemcr/luae057. eCollection 2024 Jun.

Abstract

In this report we present a case of a 14-year-old girl with type 1 diabetes mellitus (T1DM) who experienced glycemic instability and multiple hormonal deficits, including diabetes insipidus, central hypothyroidism, and central adrenal insufficiency. Brain and sellar magnetic resonance imaging revealed a mass in the suprasellar region, which was confirmed to be a pituitary abscess through transsphenoidal biopsy. T1DM is a chronic systemic disease that can lead to suboptimal glycemic control and increased susceptibility to infections. Pituitary abscess is a rare and serious infection that can manifest with nonspecific signs and symptoms, as well as pituitary hormonal deficiencies. Currently, after a 6-year follow-up the pituitary hormone deficiencies have resolved apart from persistent partial diabetes insipidus. Through a review of the current literature, we discuss the clinical characteristics of pituitary abscess, the challenges in diagnosing it, and speculate on the potential clinical and pathophysiological relationship between this uncommon infection and T1DM in our patient.

摘要

在本报告中,我们介绍了一名14岁1型糖尿病(T1DM)女孩的病例,她经历了血糖不稳定和多种激素缺乏,包括尿崩症、中枢性甲状腺功能减退和中枢性肾上腺功能不全。脑部和蝶鞍磁共振成像显示鞍上区域有一个肿块,经蝶窦活检证实为垂体脓肿。T1DM是一种慢性全身性疾病,可导致血糖控制不佳和感染易感性增加。垂体脓肿是一种罕见且严重的感染,可表现为非特异性体征和症状以及垂体激素缺乏。目前,经过6年的随访,除了持续性部分尿崩症外,垂体激素缺乏已得到缓解。通过回顾当前文献,我们讨论了垂体脓肿的临床特征、诊断挑战,并推测了这种罕见感染与我们患者的T1DM之间潜在的临床和病理生理关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/588e/11146635/1235fe68d55e/luae057f1.jpg

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