Hand-Schüller-Christian disease with occult diabetes insipidus, cardiac failure and renal dysfunction

Jpn J Med. 1990 Jul-Aug;29(4):405-10. doi: 10.2169/internalmedicine1962.29.405.

Abstract

A 60-year-old man was diagnosed as Hand-Schüller-Christian disease due to the triad of exophthalmus, decalcification of the bone, and diabetes insipidus. He had xanthogranuloma on the face and a nuchal region, and unusual complications of ADH-resistant diabetes insipidus due to renal dysfunction, and chronic cardiac failure. Urine osmolality was hypotonic, but urine volume was within the normal limit, despite the presence of central diabetes insipidus. Hypophyseal, adrenal and thyroid function were not remarkable. The skin biopsy showed the infiltration of eosinophilic granuloma cells. Treatment with vincristine was effective to regress the xanthogranuloma. Diabetes insipidus was not treated because of the absence of polyuria and polydipsia.

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury / complications*
  • Atrial Natriuretic Factor / blood
  • Blood Urea Nitrogen
  • Cardiac Output, Low / complications*
  • Deamino Arginine Vasopressin / therapeutic use
  • Diabetes Insipidus / complications*
  • Histiocytosis, Langerhans-Cell / complications
  • Histiocytosis, Langerhans-Cell / diagnosis*
  • Histiocytosis, Langerhans-Cell / drug therapy
  • Humans
  • Male
  • Middle Aged
  • Vasopressins / metabolism
  • Vincristine / therapeutic use
  • Water-Electrolyte Balance

Substances

  • Vasopressins
  • Vincristine
  • Atrial Natriuretic Factor
  • Deamino Arginine Vasopressin