{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T20:33:33Z","timestamp":1791232413441,"version":"4.1.0"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"\n Rationale<\/jats:title>\n SARS-CoV-2 infection can directly and indirectly affect the nervous system, including the hypothalamus and pituitary, and potentially cause IgG4-related hypophysitis.<\/jats:p>\n <\/jats:sec>\n \n Patient concerns<\/jats:title>\n A 4-year-old Chinese boy presented with arginine vasopressin deficiency (AVP-D, previously called \u2018central diabetes insipidus\u2019) and significant growth retardation. MRI indicated thickening of the pituitary stalk and alterations in the posterior pituitary.<\/jats:p>\n <\/jats:sec>\n \n Diagnosis<\/jats:title>\n The boy experienced polydipsia, polyuria, and enuresis 4 months after infection by SARS-CoV-2 and 2 months prior to presentation in June 2023. The diagnosis was IgG4-related hypophysitis, AVP-D, and growth hormone deficiency. Treatment with glucocorticoids and desmopressin led to significant resolution of symptoms and normalization of pituitary morphology. However, a second SARS-CoV-2 infection was followed by recurrence of polydipsia, polyuria, and thickening of the pituitary stalk. This recurrence led to a final diagnosis of IgG4-related hypophysitis caused by SARS-CoV-2 infection.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Glucocorticoids and desmopressin alleviated the AVP-D. Growth hormone and a diet and exercise plan were recommended to manage his short stature. We plan to conduct a functional assessment of the gonadal axis after he is 6 years old.<\/jats:p>\n <\/jats:sec>\n \n Outcomes<\/jats:title>\n After 18 months, the polydipsia and polyuria were controlled, and an MRI showed significant thinning of the pituitary stalk. This is the first reported case of lgG4-related hypophysitis in a Chinese boy infected with SARS-CoV-2.<\/jats:p>\n <\/jats:sec>\n \n Lessons<\/jats:title>\n We successfully controlled clinical symptoms, but further follow-up observations are needed to assess recovery. Although the role of SARS-CoV-2 infection in this patient\u2019s condition is only suggestive, other reports have described a relationship between SARS-CoV-2 infection and lgG4-related hypophysitis.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fendo.2025.1663029","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T05:18:28Z","timestamp":1763529508000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Treatment and outcome of a boy with lgG4-related hypophysitis caused by SARS-CoV-2 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