Transient central diabetes insipidus in pregnancy with a peculiar change in signal intensity on T1-weighted magnetic resonance images.
A 38-year-old woman was admitted with severe thirst and polyuria at 31 weeks' gestation. The plasma concentration of vasopressin (AVP) was very low (0.73 pg/ml) under conditions of high plasma osmolality (316 mOsm/ kg). T1-weighted magnetic resonance (MR) images revealed enlargement of the pituitary posterior lobe with absence of the hyperintense signal. After delivery, restoration of the hyperintense signal was demonstrated. This depletion-repletion process, which reflects the decrease and increase in amount of neurosecretory granules, is recognized in the case of transient central diabetes insipidus during pregnancy. We consider that an increase in cystine-aminopeptidase (CAP) activity is implicated in the pathogenesis.
Yamamoto
Tsunehiko
T
Department of Metabolism and Endocrinology, Osaka City General Hospital, 2-13- 22 Miyakojima-hondori, Miyakojima-ku, Osaka 534-0021.
Ishii
Tomofusa
T
Yoshioka
Katsunobu
K
Yamagami
Keiko
K
Yamakita
Tetsuya
T
Miyamoto
Masashi
M
Hosoi
Masayuki
M
Sato
Toshihiko
T
Tanaka
Shiro
S
Fujii
Satoru
S
D000328:Adult; D020790:Diabetes Insipidus, Neurogenic / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006965:Hyperplasia / Q000378:metabolism / Q000473:pathology; D008279:Magnetic Resonance Imaging; D010904:Pituitary Gland, Posterior / Q000378:metabolism / Q000473:pathology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D012075:Remission, Spontaneous; D018570:Risk Assessment; D014667:Vasopressins / Q000097:blood
D014667:Vasopressins