Neurosarcoidosis-induced panhypopituitarism with diabetes insipidus and subclinical multifocal pneumonitis in a young woman: A rare case report and literature review.

Neurosarcoidosis is a rare and often challenging condition that primarily affects the central nervous system, frequently leading to complex endocrine disorders. This case report presents an uncommon manifestation of neurosarcoidosis in a 30-year-old woman who developed panhypopituitarism, complicated by diabetes insipidus (DI) and subclinical multifocal pneumonitis. The patient had a 1-year history of low-grade intermittent fevers, cognitive decline, unintentional weight loss, and symptoms of DI, including excessive thirst and urination. MRI imaging revealed nodular leptomeningeal enhancement and thickening in the hypothalamic-pituitary region, which was consistent with neurosarcoidosis. A high-resolution chest CT scan revealed multifocal pneumonitis. The patient was diagnosed with panhypopituitarism secondary to neurosarcoidosis, along with DI and subclinical pneumonitis. This case emphasizes the importance of maintaining a high index of suspicion for neurosarcoidosis in patients with unexplained endocrine and neurological symptoms, especially when respiratory symptoms are subtle. Diagnosis was confirmed by clinical evaluation, imaging, and laboratory findings. Prompt diagnosis and multidisciplinary management, including hormone replacement and immunosuppressive therapy, were key in preventing further complications. Early recognition and treatment are crucial to managing neurosarcoidosis-induced panhypopituitarism and preventing permanent pituitary dysfunction. This case underscores the significance of a comprehensive diagnostic approach and increased clinical awareness in managing rare complications related to neurosarcoidosis.