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

JCEM case reports Pub Date : 2024-06-03 eCollection Date: 2024-06-01 DOI:10.1210/jcemcr/luae057
Barbara Lionetti, Nicola Minuto, Marta Bassi, Flavia Napoli
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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.

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1 型糖尿病并发尿崩症:垂体脓肿诊断。
在本报告中,我们介绍了一例患有 1 型糖尿病(T1DM)的 14 岁女孩,她的血糖不稳定,并伴有多种激素缺陷,包括糖尿病性尿崩症、中枢性甲状腺功能减退症和中枢性肾上腺功能不全。脑部和蝶窦磁共振成像显示其蝶窦上区有一肿块,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的严重感染,可表现为非特异性症状和体征,以及垂体激素缺乏。目前,经过 6 年的随访,除了持续部分性尿崩症外,垂体激素缺乏症已得到缓解。通过对现有文献的回顾,我们讨论了垂体脓肿的临床特征、诊断难题,并推测了这种不常见的感染与我们患者的 T1DM 之间潜在的临床和病理生理学关系。
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