Endocrine Abstracts

The recourse to the imagery by magnetic resonance brings to discover pathological images requiring an adapted exploration and therapeutic. The thickening of the pituitary stem can raise diagnostic difficulties. We report the case of 06 patients: 02 men and 04 women, average age is 31 years (04 years 1/2 at 48 years).

The consultation is justified by an insipid diabetes in 05 cases, an amenorrhea - galactorrhea in a case. The hormonal assessment revealed a pituitary insufficiency in n=5. The insipid diabetes is noted in 05 cases. The imagery revealed a thickening of the pituitary stem in all the cases with a macro adenoma in 01 cases and of multiple cerebral nodular images in a case.

We noted an uveite (n=2), an alteration of the optic nerve (n=2) and an encephalopathy (n=2). The etiologic assessment:

- a neuro sarcoidose in 04 cases.

- an ‘idiopathic’ cause in 02 cases. The startup of a corticotherapie allowed the disappearance of the thickening of the stem in (n=5: total, n=1: partial). And on the endocrinien plan, the disappearance of the insipid diabetes in 04 cases, and of the hyperprolactenemia with persistence of the pituitary insufficiency.

Conclusion: The thickening of the stem is a rare lesion and the diagnosis is difficult. Associated or not with pituitary alteration, it must make consider an infiltrative cause (grannulomatose…) or tumoral (supra-pituitary-infundibulaire). The ‘unspecified’ causes can appear secondarily and encourage with a clinical, biological and radio monitoring.