PMC7334767_01
(a) MRI T1-weighted sequence showing a pituitary stalk lesion with marked reinforcement and chiasmatic and hypothalamic extension. (b) Perivascular granulomas HE 10x. (c) CD 68 positive in epithelioid cells. IHQ 40x. (d) Granuloma composed by epithelioid cells and reactive gliosis at the periphery. HE 40x. MRI, magnetic resonance imaging. IHQ, immunohistochemistry. HE, hematoxylin and eosin.
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The water deprivation test, that is normally the next step in the diagnosis, was contraindicated, so we ordered a brain magnetic resonance imaging (MRI), which showed a pituitary stalk lesion with chiasmatic and hypothalamic extension (Figure 1(a)). The pathology report revealed noncaseating granulomatous inflammation and gliosis (Figures 1(b)-1(d)).
Graphical representation of serum sodium levels behavior during hospitalization. Desmopressin was administered from day 5 according to requirements.
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Treatment with desmopressin was initiated, with progressive normalization of her sodium level, urinary volume, and volemia status (Table 1) (Figure 2).