Panhypopituitarism and Central Diabetes Insipidus as a Complication of Hemorrhagic Fever with Renal Syndrome(Korean Hemorrhagic Fever)

Abstract

Panhypopituitarism and diabetes insipidus of the central type developed in a 32-year-old male patient with hemorrhagic fever with renal syndrome confirmed by indirect immunofluorescent test. Visual disturbance, loss of consciousness and neck stiffness developed during the early course of the illness followed by persistent polyuria. Combined anterior pituitary function tests showed no response in all anterior pituitary hormones. The sella CT illustrated the features of a partial empty sella. Diagnosis of diabetes insipidus was based on water deprivation and pitressin tests. Although pituitary necrosis was observed almost in all cases of hemorrhagic fever with renal syndrome at autopsy, 10 reports dealt with cases complicated by panhypopituitarism. To our knowlege, no case of central diabetes insipidus as a complication has been reported yet, so this seems to be the first.