Endocrine Abstracts

We report an interesting and important case of hypopituitarism secondary herpes encephalitis and available literature evidence.

Case history: Twenty-one year old gentleman admitted to tertiary neurosurgical unit with excessive water intake, feeling tired, increased sleepiness, a few weeks history of confusion and ‘strange behaviour’. He was oriented in person but not in place, had high temperature.

He had lumbar puncture, CT, MRI, Brain biopsy, and positive PCR for herpes virus.

He subsequently diagnosed with Herpes encephalitis and treated with Acyclovir.

He made gradual slow recovery over several months, during which was also diagnosed with diabetes insipidus. He was treated with vasopressin.

Three months after the discharge, he was re admitted to hospital with hypernatremia. Further investigations revealed hypopituitarism with diabetes insipidus. He was started on hormone replacement therapy and being closely monitored.

Further course: He is currently taking replacement therapy with hydrocortisone, thyroxin, testosterone, growth hormone and vasopressin.

Conclusion: This case illustrates an important but a rare cause of hypothalamic damage secondary to herpes encephalitis causing hypopituitarism along with diabetes insipidus. Only few case reports of similar condition have been reported in the literature.