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OXYTOCIN DEFICIENCY AND SPONTANEOUS ONSET OF LABOR AND LACTATION IN LANGERHANS CELL HISTIOCYTOSIS

Published on Sep 1, 2018in AACE clinical case reports
· DOI :10.4158/ACCR-2018-0085
Alexa Clark1
Estimated H-index: 1
,
Robyn L. Houlden16
Estimated H-index: 16
Abstract
Objective: We report a case of spontaneous vaginal delivery and lactation in a female with central diabetes insipidus and suspected oxytocin deficiency secondary to childhood Langerhans cell histiocytosis (LCH) involving the pituitary stalk. Previous case reports describe spontaneous vaginal delivery in females with panhypopituitarism without ensuing lactation. Our case is the first to report successful spontaneous vaginal delivery and lactation in a female with posterior pituitary dysfunction secondary to LCH. Methods: A 27-year-old gravida 1 para 0 woman presented with a planned natural pregnancy. She developed diabetes insipidus at age 9. Magnetic reasonance imaging (MRI) demonstrated diffuse thickening of the midline infundibular pituitary stalk suggestive of an infiltrative process, most likely LCH. She was treated with 6 months of vinblastine, 6-mercaptopurine and prednisone with normalization of pituitary stalk appearance. The diabetes insipidus persisted requiring long-term desmopressin. She was p...
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