Transient diabetes insipidus in pregnancy--a consequence of enhanced placental clearance of arginine vasopressin.
We report a patient who presented with transient diabetes insipidus in pregnancy on a background of previous postoperative diabetes insipidus following surgical excision of a prolactinoma. The patient illustrates how the complex changes in water homeostasis occurring during normal pregnancy may unmask latent diabetes insipidus. The major factors operating appear to be a physiological reduction in the thresholds for thirst and arginine vasopressin secretion coupled with a substantial increase in placental clearance of arginine vasopressin. Reversal of these changes after delivery results in normalization of the disordered water homeostasis, with consequent resolution of the diabetes insipidus.
Soule
S G
SG
Department of Medicine, University College London Medical School, UK.
Monson
J P
JP
Jacobs
H S
HS
D000328:Adult; D001127:Arginine Vasopressin / Q000378:metabolism*; D001834:Body Water / Q000378:metabolism; D003919:Diabetes Insipidus / Q000150:complications* / Q000378:metabolism*; D005260:Female; D006706:Homeostasis; D006801:Humans; D010911:Pituitary Neoplasms / Q000150:complications / Q000601:surgery; D010920:Placenta / Q000378:metabolism*; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000209:etiology* / Q000378:metabolism*; D015175:Prolactinoma / Q000150:complications / Q000601:surgery
D001127:Arginine Vasopressin