• Lei-Yi Yang, Sang Lin, Qi-Bing Xie, and Geng Yin.
• Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
• Medicine (Baltimore). 2020 Oct 23; 99 (43): e22939.

RationaleSome diseases contribute to hypopituitarism without clinical manifestations and the glucocorticoid therapy may unveil central diabetes insipidus. The condition is rare and usually causes problems for clinical physicians.Patient ConcernsA 59-year-old woman presented to our hospital due to facial numbness and persistent eyelid heaviness.DiagnosisPhysical examination and cerebrospinal fluid examination supported a diagnosis of Guillain-Barre[Combining Acute Accent] syndrome. Magnetic resonance imaging showed an empty sella. Hormone test indicated hypopituitarism.InterventionsThe patient received intravenous immunoglobulin and glucocorticoid. Central diabetes insipidus appeared after 20 days. Subsequently, the patient was prescribed 1-desamino-8-D-arginine vasopressin and prednisone.OutcomesDuring 6 months' follow-up, the patient's urine output was gradually reduced to normal level.LessonsThis case indicated that hypopituitarism may be caused by an empty sella and be masked by adrenal insufficiency. Central diabetes insipidus may present after glucocorticoid therapy.

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