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【medical-news】尿崩症的罕见原因
CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL, Case 25-2008: A 43-Year-Old Man with Fatigue and Lesions in the Pituitary and Cerebellum, J.A. Mills, R.G. Gonzalez, and R. Jaffe
A 43-year-old man presented with fatigue and had been diagnosed with diabetes insipidus years earlier. He was eventually determined to have lesions in his pituitary and cerebellum detected on radiography. An MRI revealed a suprasellar mass and nodule in the left cerebellar hemisphere. Also, a CT of the chest, abdomen, and pelvis showed sclerotic foci in the shoulder, spine, and pelvis, and iliac crest. Are any of these lesions associated with his diabetes insipidus?
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Clinical Pearls
Causes of Diabetes Insipidus
The list of possible causes of diabetes insipidus in this case and many others is extensive and includes infection (tuberculous pachymeningitis and Whipple's disease), malignant neoplasms (germ-cell tumor and lymphoma), infiltrative processes (hemochromatosis and amyloidosis), autoimmune diseases (Wegener's granulomatosis, lymphocytic infundibulitis, and sarcoidosis), and histiocytosis (Langerhans'-cell histiocytosis and non-Langerhans'-cell histiocytosis).
Langerhans'-cell Histiocytosis
Langerhans'-cell histiocytosis is a neoplasm of dendritic-cell origin that may cause pituitary dysfunction due to involvement of the infundibulum, a form known as Hand–Schüller–Christian disease. Patients with this condition often have lesions of the calvaria, long bones, and ribs, and sclerotic lesions were reported in multiple bones in this patient on CT and MRI. The bone lesions in Langerhans'-cell histiocytosis are typically lytic rather that sclerotic.
from new england journal of medicine 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 Case: Diabetes Insipidus with an Unusual Cause
CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL, Case 25-2008: A 43-Year-Old Man with Fatigue and Lesions in the Pituitary and Cerebellum, J.A. Mills, R.G. Gonzalez, and R. Jaffe
病例报告：一例罕见原因引起的尿崩症
曼彻斯特医院的病例记录，病例25-2008：1例43岁男性患者表现疲乏及垂体后叶和小脑损伤。J.A. Mills, R.G. Gonzalez, and R. Jaffe
A 43-year-old man presented with fatigue and had been diagnosed with diabetes insipidus years earlier. He was eventually determined to have lesions in his pituitary and cerebellum detected on radiography. An MRI revealed a suprasellar mass and nodule in the left cerebellar hemisphere. Also, a CT of the chest, abdomen, and pelvis showed sclerotic foci in the shoulder, spine, and pelvis, and iliac crest. Are any of these lesions associated with his diabetes insipidus?
1例43岁的男性患者表现疲乏症状，早年诊断患有尿崩症。最终通过放射检查发现垂体后叶和小脑的损伤。MRI检查发现蝶鞍上有一肿块以及左小脑半球一结节病灶。而且，胸部、腹部和盆腔CT检查发现肩部、脊柱、盆骨和髂嵴部位存在钙化灶。这些病损是否与其尿崩症有关？
top
Clinical Pearls
Causes of Diabetes Insipidus
The list of possible causes of diabetes insipidus in this case and many others is extensive and includes infection (tuberculous pachymeningitis and Whipple's disease), malignant neoplasms (germ-cell tumor and lymphoma), infiltrative processes (hemochromatosis and amyloidosis), autoimmune diseases (Wegener's granulomatosis, lymphocytic infundibulitis, and sarcoidosis), and histiocytosis (Langerhans'-cell histiocytosis and non-Langerhans'-cell histiocytosis).
尿崩症病因
这例病例其他许多病例尿崩症的可能病因广泛，包括感染(结核性脑脊髓膜炎和Whipple病) ，恶性肿瘤（生殖细胞肿瘤和淋巴瘤），变性疾病（血色病和淀粉样变性），自身免疫病（Wegener肉芽肿，垂体茎淋巴细胞瘤和粒细胞肉瘤）和组织细胞增生症（Langerhans细胞和非Langerhans细胞组织细胞增生症）
Langerhans'-cell Histiocytosis
Langerhans'-cell histiocytosis is a neoplasm of dendritic-cell origin that may cause pituitary dysfunction due to involvement of the infundibulum, a form known as Hand–Schüller–Christian disease. Patients with this condition often have lesions of the calvaria, long bones, and ribs, and sclerotic lesions were reported in multiple bones in this patient on CT and MRI. The bone lesions in Langerhans'-cell histiocytosis are typically lytic rather that sclerotic.
Langerhans细胞组织细胞增生症
Langerhans细胞组织细胞增生症是一种树突细胞来源的肿瘤，其中Hand–Schüller–Christian累及垂体茎可引起尿崩症。这些患者的CT和 MRI检查可以发现患者的颅盖骨、长骨、肋骨的溶骨性病变，及多处骨骼的硬化性病变。在Langerhans细胞组织细胞增生症患者的骨病变中溶骨性病变多于硬化性病
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病例报告：一例罕见原因引起的尿崩症
曼彻斯特医院的病例记录，病例25-2008：1例43岁男性患者表现疲乏及垂体后叶和小脑损伤。J.A. Mills, R.G. Gonzalez, and R. Jaffe
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作者:admin@医学,生命科学 2011-02-13 05:11
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