{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T07:06:45Z","timestamp":1765609605231},"reference-count":20,"publisher":"The Endocrine Society","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1997,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>We report nine consecutive children and adolescents [five females and four males; aged 2 yr 8 months (m) to 18 yr 1 m] studied over the last 5 yr with idiopathic central diabetes insipidus. In addition to vasopressin deficiency, anterior pituitary hormone deficiencies were detected, either on evaluation at presentation or during follow-up studies over the following 3 yr. Four patients had an increased concentration of plasma PRL. One patient had multiple pituitary hormone deficiencies at diagnosis, and two others developed the same by 21 m of follow-up. Brain magnestic resonance imaging scans, performed at presentation, were originally interpreted as normal in four of nine patients, except for absence of the bright posterior pituitary signal; after retrospective review, two of nine were considered normal. All of the brain magnetic resonance imaging (MRI) scans showed positive findings by 14 m of follow-up. The first abnormal finding in all patients was isolated pituitary stalk thickening. Evaluation of cerebrospinal fluid (CSF) for hCG was positive in three of eight evaluated patients; the three positive CSF values were found at presentation and 3 and 9 m after presentation. All eight patients assessed were negative for CSF \u03b1-fetoprotein and cytology, and no patient had serum tumor markers. Transsphenoidal biopsy of the lesion in seven of nine patients showed a germinoma in six patients and inflammatory cells in one. The six patients with documented germinoma comprise 31% of the intracranial germinomas diagnosed in this age group at the University of California-San Francisco during the last 5 yr. The patient with mononuclear inflammatory cells on biopsy along with one other patient have had spontaneous resolution of their stalk thickening. So-called \u201cidiopathic\u201d central diabetes insipidus warrants close follow-up to determine the etiology, especially if anterior pituitary hormone deficiencies are detected. Normal brain MRI scans or scans that show isolated pituitary stalk thickening merit follow-up with serial contrast enhanced brain MRI for the early detection of an evolving occult hypothalamic-stalk lesion. CSF evaluation is recommended at presentation because elevated CSF hCG may precede MRI abnormalities.<\/jats:p>","DOI":"10.1210\/jcem.82.5.3955","type":"journal-article","created":{"date-parts":[[2014,1,8]],"date-time":"2014-01-08T17:01:45Z","timestamp":1389200505000},"page":"1362-1367","source":"Crossref","is-referenced-by-count":9,"title":["Idiopathic Hypothalamic Diabetes Insipidus, Pituitary Stalk Thickening, and the Occult Intracranial Germinoma in Children and Adolescents*"],"prefix":"10.1210","volume":"82","author":[{"given":"Sudha L.","family":"Mootha","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Divisions of Neuroradiology (A.J.B.), San Francisco, California 94143"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony J.","family":"Barkovich","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Divisions of Neuroradiology (A.J.B.), San Francisco, California 94143"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melvin M.","family":"Grumbach","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Divisions of Neuroradiology (A.J.B.), San Francisco, California 94143"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael S.","family":"Edwards","sequence":"additional","affiliation":[{"name":"Pediatric Neurosurgery (M.S.E.), University of California, San Francisco, California 94143"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen E.","family":"Gitelman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Divisions of Neuroradiology (A.J.B.), San Francisco, California 94143"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Selna L.","family":"Kaplan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Divisions of Neuroradiology (A.J.B.), San Francisco, California 94143"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix A.","family":"Conte","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Divisions of Neuroradiology (A.J.B.), San Francisco, California 94143"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","reference":[{"key":"2020071615142438600_R1","first-page":"37","article-title":"Le diabe\u0300te pitressosensible de l\u2019enfant.","volume":"37","author":"Pomarede","year":"1980","journal-title":"Arch Fr Pediatr"},{"key":"2020071615142438600_R2","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1001\/archpedi.1986.02140200061028","article-title":"Central diabetes insipidus.","volume":"140","author":"Greger","year":"1986","journal-title":"Am J Dis Child"},{"key":"2020071615142438600_R3","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/0887-8994(94)90001-9","article-title":"Etiologies of central diabetes insipidus in children.","volume":"11","author":"Wang","year":"1994","journal-title":"Pediatr Neurol"},{"key":"2020071615142438600_R4","first-page":"157","article-title":"A water deprivation test for the diagnosis of diabetes insipidus in children.","volume":"114","author":"Frasier","year":"1967","journal-title":"Am J Dis Child"},{"key":"2020071615142438600_R5","first-page":"839","article-title":"Simplifying the diagnosis of diabetes insipidus in children.","volume":"135","author":"Richman","year":"1981","journal-title":"Am J Dis Child"},{"key":"2020071615142438600_R6","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1056\/NEJM196801112780201","article-title":"Growth and growth hormone. 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A comparison of isolated growth hormone deficiency and multiple hormone deficiencies in 35 patients with hypopituitary dwarfism.","volume":"278","author":"Goodman","year":"1968","journal-title":"N Engl J Med"},{"key":"2020071615142438600_R7","author":"Grumbach","year":"1974"},{"key":"2020071615142438600_R8","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1210\/jcem-52-1-9","article-title":"Hormonal and metabolic abnormalities associated with central nervous system germinoma in children and adolescents and the effect of therapy: report of 10 patients.","volume":"52","author":"Sklar","year":"1981","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071615142438600_R9","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1159\/000182694","article-title":"Idiopathic hypothalamus-pituitary dysfunction: review of five cases.","volume":"39","author":"Cianfarani","year":"1993","journal-title":"Horm Res"},{"key":"2020071615142438600_R10","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/S0022-3476(85)80461-3","article-title":"Diabetes insipidus in children. 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