[Diabetes insipidus and postpartum anterior hypophyseal insufficiency].
There have only been thirty cases of total post-partum hypopituitarism published in the literature and these have nearly all been secondary to Sheehan's syndrome. The authors report a case of partial anterior hypopituitarism associated with diabetes insipidus which arose after an uneventful Caesarean operation and the origin of which seems to lie in auto-immune hypophysitis. The authors first describe the morphological and endocrine changes that the hypophysis undergoes during pregnancy and then point out that auto-immune hypophysitis seems to have been only recently recognised. This can be used to explain some cases of post-partum hypophyseal insufficiency occurring almost silently without any history of third haemorrhage. Research has been made systematically for anti-hypophyseal antibodies and for specific antibodies of the organ, but has not always been positive. So the diagnosis of auto-immune hypophysitis is often made only after eliminating other reasons for it. A brief review of the physiopathological mechanisms of diabetes insipidus makes it possible to suggest that vasopressinase coming from the placenta together with prostaglandins could play a role.
Tordjeman
N
N
Service de Gynécologie-Obstétrique, C.H.U., Lille.
Monnier
J C
JC
Vantyghem-Haudiquet
M C
MC
Bouthors-Ducloy
A S
AS
Vinatier
D
D
D000328:Adult; D001327:Autoimmune Diseases / Q000150:complications / Q000175:diagnosis / Q000276:immunology / Q000503:physiopathology / Q000628:therapy; D002585:Cesarean Section; D010122:Cystinyl Aminopeptidase / Q000502:physiology; D003894:Deamino Arginine Vasopressin / Q000494:pharmacology / Q000627:therapeutic use; D003919:Diabetes Insipidus / Q000150:complications / Q000175:diagnosis / Q000276:immunology / Q000503:physiopathology / Q000628:therapy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007018:Hypopituitarism / Q000150:complications / Q000175:diagnosis / Q000276:immunology / Q000503:physiopathology / Q000628:therapy; D008279:Magnetic Resonance Imaging; D010903:Pituitary Gland, Anterior; D011247:Pregnancy; D011453:Prostaglandins / Q000502:physiology; D011644:Puerperal Disorders / Q000150:complications / Q000175:diagnosis / Q000276:immunology / Q000503:physiopathology / Q000628:therapy
D011453:Prostaglandins; D010122:Cystinyl Aminopeptidase; D003894:Deamino Arginine Vasopressin
Diabète insipide et insuffisance antéhypophysaire du post-partum.