title: Acute presentation of gestational diabetes insipidus with pre-eclampsia complicated by cerebral vasoconstriction: a case report and review of the published work.
abstract: Gestational diabetes insipidus (GDI) is a rare, self-limited complication of pregnancy. As it is related to excess placental vasopressinase enzyme activity, which is metabolized in the liver, GDI is more common in pregnancies complicated by conditions associated with liver dysfunction. We present a case of a 41-year-old woman at 38 weeks' gestation who presented with pre-eclampsia with severe features, including impaired liver function and renal insufficiency. Following cesarean section she was diagnosed with GDI, which was further complicated by cerebral vasoconstriction as demonstrated by magnetic resonance angiography. This case raises the possibility that cerebral vasoconstriction may be related to the cause of GDI. A high index of suspicion of GDI should be maintained in patients who present with typical signs and symptoms, especially in the setting of pregnancy complications associated with liver dysfunction.
authors.affiliation: Department of Obstetrics and Gynecology, Maimonides Medical Center, New York, New York.
authors.forename: Amir
authors.initials: A
authors.lastname: Mor
authors.affiliation: Department of Obstetrics and Gynecology, Maimonides Medical Center, New York, New York.
authors.forename: Yael
authors.initials: Y
authors.lastname: Fuchs
authors.affiliation: Department of Obstetrics and Gynecology, Maimonides Medical Center, New York, New York.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Zafra
authors.affiliation: Department of Obstetrics and Gynecology, Maimonides Medical Center, New York, New York.
authors.forename: Shoshana
authors.initials: S
authors.lastname: Haberman
authors.affiliation: Department of Obstetrics and Gynecology, Maimonides Medical Center, New York, New York.|Division of Reproductive Endocrinology & Infertility, Department of Obstetrics and Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut, USA.
authors.forename: Reshef
authors.initials: R
authors.lastname: Tal
mesh_terms: D000328:Adult; D002560:Cerebrovascular Circulation; D003919:Diabetes Insipidus / Q000209:etiology*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D011225:Pre-Eclampsia; D011247:Pregnancy; D014661:Vasoconstriction
keywords: case report; cerebral vasoconstriction; gestational diabetes insipidus; pre-eclampsia