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Magnetic resonance imaging and symptoms in patients with neurosarcoidosis and central diabetes insipidus
, 1, 1, 1, 1, 1, 2, 1, 1, 3, 3, 3
Affiliations- Department of General Medicine, Tottori Municipal Hospital, Tottori-City, Tottori, Japan
- Department of Internal Medicine, Tottori Municipal Hospital, Tottori-City, Tottori, Japan
- Center for Community Medicine, Jichi Medical University, Shimotsuke-City, Tochigi, Japan
open access
Abstract
Introduction: In the clinical setting, the diagnosis of neurosarcoidosis in patients with central diabetes insipidus (CDI) is typically based both on symptoms (i.e. polydipsia or polyuria) and brain magnetic resonance imaging (MRI) findings (e.g. pituitary abnormality). However, inconsistent changes in the patient’s symptoms and brain MRI findings may occur during the clinical course of the disease. This review was performed to summarise the relationship between symptoms and brain MRI findings in previously reported cases of neurosarcoidosis with CDI.
Material and methods: Case studies of patients diagnosed with neurosarcoidosis with CDI were collected via a PubMed search of studies published through 30 June 2018.
Results: Thirteen eligible studies were reviewed (20 patients; 12 men, 8 women; mean age 33 years). Polydipsia or polyuria was the first symptom in 13 patients. The mean duration from disease onset to diagnosis was 3.4 months. Brain MRIs showed abnormal findings in the hypothalamus and pituitary for 17 patients. Immunosuppressive drugs were used in 17 patients. For 14 patients, MRI findings improved, while symptoms did not.
Conclusion: Patients with both neurosarcoidosis and CDI symptoms often do not improve, despite the fact that brain MRI findings often improve following treatment. More studies involving detailed pathological analyses and longer follow-up periods are necessary.
Abstract
Introduction: In the clinical setting, the diagnosis of neurosarcoidosis in patients with central diabetes insipidus (CDI) is typically based both on symptoms (i.e. polydipsia or polyuria) and brain magnetic resonance imaging (MRI) findings (e.g. pituitary abnormality). However, inconsistent changes in the patient’s symptoms and brain MRI findings may occur during the clinical course of the disease. This review was performed to summarise the relationship between symptoms and brain MRI findings in previously reported cases of neurosarcoidosis with CDI.
Material and methods: Case studies of patients diagnosed with neurosarcoidosis with CDI were collected via a PubMed search of studies published through 30 June 2018.
Results: Thirteen eligible studies were reviewed (20 patients; 12 men, 8 women; mean age 33 years). Polydipsia or polyuria was the first symptom in 13 patients. The mean duration from disease onset to diagnosis was 3.4 months. Brain MRIs showed abnormal findings in the hypothalamus and pituitary for 17 patients. Immunosuppressive drugs were used in 17 patients. For 14 patients, MRI findings improved, while symptoms did not.
Conclusion: Patients with both neurosarcoidosis and CDI symptoms often do not improve, despite the fact that brain MRI findings often improve following treatment. More studies involving detailed pathological analyses and longer follow-up periods are necessary.
Keywords
neurosarcoidosis; central diabetes insipidus; pituitary; pituitary stalk; prednisolone
About this articleTitle
Magnetic resonance imaging and symptoms in patients with neurosarcoidosis and central diabetes insipidus
Journal
Issue
Article type
Review paper
Pages
430-437
Published online
2019-10-25
Page views
1821
Article views/downloads
1731
DOI
Pubmed
Bibliographic record
Endokrynol Pol 2019;70(5):430-437.
Keywords
neurosarcoidosis
central diabetes insipidus
pituitary
pituitary stalk
prednisolone
Authors
Eiichi Kakehi
Seiji Adachi
Yusuke Fukuyasu
Yasuhiro Hashimoto
Shigehisa Sakurai
Akane Hirotani
Hisanori Danbara
Kaduyo Shimizu
Ryosuke Fujita
Hiroyuki Teraura
Kazuhiko Kotani
Masami Matsumura
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