J Korean Endocr Soc.  2006 Dec;21(6):482-489.

Retrospective Observation of Long-Term Clinical Courses of Idiopathic Central Diabetes Insipidus in Adults

• Kim HJ
• Kang MY
• Kim KW
• Jeong HS
• Kim HS
• Kim SW
• Kim SY

Abstract

BACKGROUND: Idiopathic central diabetes insipidus (CDI) can be diagnosed when it occurs in the absence of a genetic or secondary cause known to be responsible for diabetes insipidus (DI). Some studies have reported that idiopathic CDI in adults shows a more benign clinical course than in children and young patients. However, the clinical characteristics and progress of this disorder have not been fully described. Therefore, we investigated the clinical courses of adult patients over the age of sixteen years with idiopathic central DI.
METHODS
We reviewed the medical records of all patients who had documented cases of idiopathic CDI from 1989 to 2005, and studied clinical features, hormone data, and imaging studies at diagnosis and during at least 1-year of follow-up.
RESULTS
There were 9 male (30.0%) and 21 female (70.0%) patients with a mean age of 39.3 years at diagnosis and a mean follow-up duration of 6.9 years. At diagnosis, deficits in anterior pituitary hormones were documented in 6 patients (20%), hyperprolactinemia in 4, and hypogonadism in 2. Two patients had an anterior pituitary hormone deficiency that was newly detected at a mean 3.4 years after the onset of DI. On initial MRI, the posterior pituitary was not hyperintense in 7 of the 30 patients (23.3%), but pituitary stalk thickening was observed in 15 (50.0%). After a mean follow-up of 6.9 years (range: 1 to 18), follow-up pituitary MRI showed improvement or no changes in patients with initial MRI findings of a pituitary abnormality, and no development of new lesions in 7 patients with a normal pituitary finding on initial MRI.
CONCLUSION
Two of the 30 patients with idiopathic CDI developed an anterior pituitary hormone deficiency during follow-up, but no subject showed any aggravation on follow-up MRI. No patient showed a newly developed pituitary abnormality on follow-up MRI after a negative finding on the initial MRI.

Keyword

Anterior pituitary hormone; Clinical course; Idiopathic diabetes insipidus; MRI; Pituitary

MeSH Terms

Adult*
Child
Diabetes Insipidus
Diabetes Insipidus, Neurogenic*
Diagnosis
Female
Follow-Up Studies
Humans
Hyperprolactinemia
Hypogonadism
Magnetic Resonance Imaging
Male
Medical Records
Pituitary Gland
Pituitary Hormones, Anterior
Retrospective Studies*
Pituitary Hormones, Anterior

Figure

• 

  Fig. 1 Age distribution of patients with idiopathic central diabetes insipidus. Our study showed the peak in the age-group 30-39.

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