Central Diabetes Insipidus and Hypothalamic Type of Hypopituitarism Associated with Atypical Location of Rathke's Cleft Cyst

January 2012 in “ Internal Medicine ”

Tomoko Asano, Atsushi Aoki, Masami Sasaki, Aki Ikoma, Hideo Toyoshima, Masanobu Kawakami, Ichiro Fujisawa, San‐e Ishikawa

central diabetes insipidus hypothalamic hypopituitarism Rathke's cleft cyst ACTH LH FSH GH IGF-1 prolactin AVP hypertonic saline antidiuretic hormone growth hormone luteinizing hormone follicle-stimulating hormone adrenocorticotropic hormone

TLDR A Rathke's cleft cyst caused hormonal imbalances and symptoms in a 68-year-old woman.

A 68-year-old woman exhibited symptoms of weight loss, polyuria, and hair loss in various regions, which were linked to central diabetes insipidus and hypothalamic hypopituitarism due to an atypically located Rathke's cleft cyst. Laboratory tests showed low levels of several hormones, including ACTH, LH, FSH, GH, and IGF-1, with a high level of prolactin. Hormonal responses were observed with exogenous hormone stimulation but not with insulin-induced hypoglycemia or clomiphene. The patient had a high urine volume with low osmolality and inadequate AVP response to hypertonic saline. MRI confirmed the presence of a Rathke's cleft cyst at the pituitary stalk, explaining the hormonal imbalances and symptoms.

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