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Langerhans cell (LCH) histiocytosis occurs in 1 per 560,000 adults with variable manifestations. However, it rarely presents with simultaneous and multiple endocrine dysfunctions early in the course of the disease. We report a case of LCH in an adult manifesting with adipsic diabetes insipidus, diabetes mellitus and hypopituitarism.A 41-year-old Filipino male presented with polyuria and polydipsia. He was initially diagnosed as a simple case of diabetes mellitus but symptoms did not fully resolve after control of glucose. He had loss of thirst perception, erectile dysfunction and memory impairment. These were followed by crusting skin lesions over the face, trunk and extremities. He was hospitalized because of altered mentation because of severe dehydration, hypernatremia and hyperglycemia. Subsequent work-up showed thickened hypothalamus and infundibulum on magnetic resonance imaging. Skin biopsy and immunostaining with S-100 and CD1a confirmed the diagnosis. There was partial improvement after chemotherapy. He was maintained on desmopressin and testosterone.Multiple endocrinopathies can be the presenting signs of adult-onset LCH. They can be harbinger of subsequent involvement of other organs. Central diabetes insipidus, other hypothalamic dysfunctions and anterior pituitary hormonal deficiencies, when present at the onset as in this case, will likely have poor response to treatment despite improvement of other non-endocrine organs. The permanent lesions in the hypothalamus and pituitary gland warrants continued endocrine evaluation and intervention. Keywords: Langerhans cell histiocytosis, Adult, Adipsic diabetes insipidus, Diabetes mellitus, Hypopituitarism

Although survival rate in papillary thyroid cancer (PTC) is high, the risk of persistence and recurrence together with the dramatic rise in its incidence cannot be overemphasized. Filipinos are considered to be at greater risk for negative outcomes. A paradigm shift in the management of PTC introduces re-stratification based on response to therapy which was reported to have better correlation with long-term outcome. The study aimed to identify predictors of incomplete response after thyroidectomy and radioiodine therapy among patients with PTC. The results of the study may have important implications in our understanding of the disease process allowing more aggressive treatment and monitoring of certain subgroups of patients. Retrospective review of 225 patients with PTC (59 % ATA low risk, 30 % ATA intermediate risk and 11 % ATA high risk) who underwent thyroidectomy and radioiodine therapy was performed. Thirteen variables were considered (age, gender, histopathological variant, stage, extent of disease, MACIS score, AMES score, primary tumour size, lymph node, lymphovascular invasion, bilaterality, multifocality and preoperative TSH level). Logistic regression analysis using Backward Wald algorithm was used to identify independent predictors of incomplete response to therapy after 24 months. Of the 225 patients, 69 (31 %) had incomplete response. Biochemical and structural (predominantly thyroid bed, lung and bone) incomplete response was observed in 6 and 63 patients, respectively. Incomplete response was documented in 8, 54 and 92 % of low-, intermediate- and high-risk patients based on ATA recommendation. Incomplete response was significantly dependent on gender, lymph node involvement and location, extent of malignancy and multifocality taking into account the size of concurrent tumours (p