The Intersection of Hypophysitis and Central Diabetes Insipidus: A Clinical Case Report

Authors

Sanjana Kesireddy, HCA HealthcareFollow
Brina Gonzalez, HCA HealthcareFollow
Mohan Sengodan, HCA HealthcareFollow

Files

Division

North Texas

Hospital

Medical City Fort Worth

Specialty

Internal Medicine

Document Type

Poster

Publication Date

2025

Keywords

hypophysitis, diabetes, pituitary diseases, diabetes insipidus

Disciplines

Endocrine System Diseases | Internal Medicine | Medicine and Health Sciences | Nervous System Diseases

Abstract

INTRODUCTION: Hypophysitis can cause damage to the posterior pituitary, which in turn impairs the production or release of ADH, leading to the symptoms of central diabetes insipidus. Without enough ADH, the kidneys cannot concentrate urine, resulting in the symptoms of excessive thirst and urination seen in central diabetes insidious. CASE PRESENTATION: 27 year old female presents with excessive thirst, headache, nausea and vomiting. Patient had increased urine output since endoscopic trans sphenoidal resection of pituatary mass. She was started on desmpressin 0.2mg orally three times a day. Based on urine specific gravity and urine output per hour, IV desmopressin was added and titrated to decrease urine output. Patient was able to wean off IV desmopressin and discharged home with a tapering course to desmopressin 0.1 orally twice a day for 7 days to a maintenance dose of Desmopressin 0.1 mg daily indefinitely. Additionally, patient was discharged home with steroid dosing of Hydrocortisone 10mg in the morning and Hydrocortisone 5mg in the evening as a maintenance dose. LEARNING POINTS: It was crucial for the patient to be on steroids to reduce inflammation and treat the hypophysitis. It’s crucial that steroid dosing is tailored to the individual patient and adjusted based on factors like the underlying cause, response to treatment, and side effects. The connection between hypophysitis and central diabetes insipidus is that hypophysitis can directly impair the pituitary’s ability to release ADH, which is crucial for regulating the body's water balance. Serial checks of urine specific gravity is important for adjusting desmopressin dosages to ensure effective treatment and avoid complications. For maintenance dosage in patients with central diabetes insipidus secondary to hypophysitis, desmopressin is adjusted to ensure urine specific gravity remains within a normal range, typically around 1.010 to 1.020.

Original Publisher

HCA Healthcare Graduate Medical Education

Recommended Citation

Kesireddy, Sanjana; Gonzalez, Brina; and Sengodan, Mohan, "The Intersection of Hypophysitis and Central Diabetes Insipidus: A Clinical Case Report" (2025). North Texas Research Forum 2025. 15.
https://scholarlycommons.hcahealthcare.com/northtexas2025/15