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Introduction <p>Hypothalamic dysfunction may result in a wide range of endocrine and non-endocrine manifestations, including pituitary hormone deficiencies, disorders of water balance, obesity, thermoregulatory disturbances, autonomic dysfunction, behavioural changes, and sleep abnormalities. These complications often require long-term follow-up and periodic reassessment.</p> Case Presentation <p>An 11-year-old girl presented with headache and impaired vision of both eyes for one month. Examination showed body mass index of 20.4&#xa0;kg/m², breast Tanner stage IV, pubic hair stage I, and absent axillary hair. Magnetic resonance imaging revealed a 3.9 × 4.5&#xa0;cm sellar-suprasellar multicystic lesion with obstructive hydrocephalus. She underwent craniotomy with excision and radiotherapy; histopathology confirmed adamantinomatous craniopharyngioma. Postoperatively, she developed central hypothyroidism, adrenal insufficiency, and adipsic central diabetes insipidus requiring hormone replacement with fluid balance monitoring. On follow-up, she developed recurrent and severe anemia with thrombocytopenia, during which axillary temperatures of 35.5–36.2&#xa0;°C were noted. As her body temperature normalized, her hematological parameters improved. Additional findings included pubertal arrest with hypogonadism requiring estradiol therapy, hypothalamic obesity, cognitive decline, and right hemiparesis due to middle cerebral artery infarct.</p> Conclusion <p>Postoperative management of craniopharyngioma is often complicated by involvement of multiple hypothalamic domains. This case emphasizes the importance of recognizing uncommon and underreported manifestations, such as thermoregulation-associated cytopenia and adipsic diabetes insipidus. Early diagnosis and multidisciplinary management are essential for improving outcomes and long-term quality of life in affected children.</p>

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Bicytopenia - A Rare Hematological Manifestation Secondary to Hypothalamic Dysfunction in a Case of Craniopharyngioma: A Case Report

  • 期刊论文

  • 发表日期：

    2025年12月10日

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  • Amritava Ghosh,
  • Nikhil Sanjeev K,
  • Saroj Bala

摘要

Introduction

Hypothalamic dysfunction may result in a wide range of endocrine and non-endocrine manifestations, including pituitary hormone deficiencies, disorders of water balance, obesity, thermoregulatory disturbances, autonomic dysfunction, behavioural changes, and sleep abnormalities. These complications often require long-term follow-up and periodic reassessment.

Case Presentation

An 11-year-old girl presented with headache and impaired vision of both eyes for one month. Examination showed body mass index of 20.4 kg/m², breast Tanner stage IV, pubic hair stage I, and absent axillary hair. Magnetic resonance imaging revealed a 3.9 × 4.5 cm sellar-suprasellar multicystic lesion with obstructive hydrocephalus. She underwent craniotomy with excision and radiotherapy; histopathology confirmed adamantinomatous craniopharyngioma. Postoperatively, she developed central hypothyroidism, adrenal insufficiency, and adipsic central diabetes insipidus requiring hormone replacement with fluid balance monitoring. On follow-up, she developed recurrent and severe anemia with thrombocytopenia, during which axillary temperatures of 35.5–36.2 °C were noted. As her body temperature normalized, her hematological parameters improved. Additional findings included pubertal arrest with hypogonadism requiring estradiol therapy, hypothalamic obesity, cognitive decline, and right hemiparesis due to middle cerebral artery infarct.

Conclusion

Postoperative management of craniopharyngioma is often complicated by involvement of multiple hypothalamic domains. This case emphasizes the importance of recognizing uncommon and underreported manifestations, such as thermoregulation-associated cytopenia and adipsic diabetes insipidus. Early diagnosis and multidisciplinary management are essential for improving outcomes and long-term quality of life in affected children.