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Nine of the 17 patients had thickening of the pituitary stalk,enlargement of the neurohypophysis,or both and lacked the hyperintense signal of the normal neurohypophysis.In the remaining eight patients,the pituitary stalk and the neurohypophysis were normal,although the hyperintense signal was absent.The abnormalities of thickening and enlargement were seen on MRI only in the patients who had had diabetes insipidus for less than two years,and the abnormalities disappeared during follow-up,suggesting a self-limited process.In addition to vasopressin deficiency,two patients had mild hyperprolactinemia and nine had impaired secretory responses of growth hormone to insulin-induced hypoglycemia.The two biopsies revealed chronic inflammation,with infiltration of lymphocytes(mainly T lymphocytes)and plasma cells.Diabetes insipidus can be caused by lymphocytic infundibuloneurohypophysitis,which can be detected by MRI.The natural course of the disorder is self-limited. |
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