Approach to the patients with Langerhans cell histiocytosis first manifested as central diabetes insipidus

VernacularTitle:以中枢性尿崩为首发表现的朗格汉斯细胞组织细胞增生症的临诊应对
Author: Mingwei SHAO ; Yanxia LIU ; Lin ZHAO ; Mengqing LIAN ; Lin XIAO ; Guijun QIN
From: Chinese Journal of Endocrinology and Metabolism 2021;37(3):235-239
CountryChina
Language:Chinese
Abstract: Three cases of Langerhans cell histiocytosis (LCH)with central diabetes insipidus as the first manifestation were reported, with the summary of their clinical manifestations, laboratory examinations, imaging examinations, pathological results, diagnosis process, and treatment response. All three patients presented with central diabetes insipidus in the early stage. The pituitary magnetic resonance imaging (MRI)showed thickened pituitary stalks, and all lost the normal high signal of the posterior pituitary. Two patients showed isolated hypothalamic-pituitary lesions, while one case showed pituitary and thyroid systems involvement. Pathological findings showed typical Langerhans cells, immunohistochemistry showed positive for S-100, CD1a, Langerin. The clinical manifestations of LCH manifested distinct heterogeneity, which is easy to be misdiagnosed and left out. The diagnosis should be confirmed by pathological examination. The biopsy of isolated hypothalamic-pituitary lesions is difficult. It is recommended to actively screen other organs to increase the probability of biopsy. LCH-induced neurohypophysis requires life-long hormone replacement therapy.