Autoimmune central diabetes insipidus in a patient with ureaplasma urealyticum infection and review on new triggers of immune response.
Diabetes insipidus is a disease in which large volumes of dilute urine (polyuria) are excreted due to vasopressin (AVP) deficiency [central diabetes insipidus (CDI)] or to AVP resistance (nephrogenic diabetes insipidus). In the majority of patients, the occurrence of CDI is related to the destruction or degeneration of neurons of the hypothalamic supraoptic and paraventricular nuclei. The most common and well recognized causes include local inflammatory or autoimmune diseases, vascular disorders, Langerhans cell histiocytosis (LCH), sarcoidosis, tumors such as germinoma/craniopharyngioma or metastases, traumatic brain injuries, intracranial surgery, and midline cerebral and cranial malformations. Here we have the opportunity to describe an unusual case of female patient who developed autoimmune CDI following ureaplasma urealyticum infection and to review the literature on this uncommon feature. Moreover, we also discussed the potential mechanisms by which ureaplasma urealyticum might favor the development of autoimmune CDI.
Department of Internal Medicine and Medical Specialties, University of Genoa, Genova, Italy.
Giuseppe
G
Murdaca
Department of Internal Medicine and Medical Specialties, University of Genoa, Genova, Italy.
Rodolfo
R
Russo
Department of Internal Medicine and Medical Specialties, University of Genoa, Genova, Italy.
Francesca
F
Spanò
Endocrinology Units, Department of Internal Medicine and Medical Specialties, University of Genoa, Genova, Italy.
Diego
D
Ferone
Endocrinology Units, Department of Internal Medicine and Medical Specialties, University of Genoa, Genova, Italy.
Manuela
M
Albertelli
Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, IRCCS AOU San Martino-IST, University of Genoa, Genova, Italy.
Angelo
A
Schenone
Department of Internal Medicine and Medical Specialties, University of Genoa, Genova, Italy.
Miriam
M
Contatore
Department of Internal Medicine and Medical Specialties, University of Genoa, Genova, Italy.
Andrea
A
Guastalla
Endocrinology Unit, Department of Clinical and Experimental Medicine and Surgery F. Magrassi-A. Lanzara, Second University of Naples, Naples, Italy.
Annamaria
A
De Bellis
Department of Internal Medicine and Medical Specialties, University of Genoa, Genova, Italy.
Giacomo
G
Garibotto
Department of Internal Medicine and Medical Specialties, University of Genoa, Genova, Italy.
Francesco
F
Puppo
D016918:Arthritis, Reactive / Q000276:immunology* / Q000382:microbiology; D001323:Autoantibodies; D001327:Autoimmune Diseases / Q000209:etiology / Q000382:microbiology*; D020790:Diabetes Insipidus, Neurogenic / Q000209:etiology / Q000276:immunology / Q000382:microbiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009481:Neurophysins / Q000276:immunology; D011498:Protein Precursors / Q000276:immunology; D016869:Ureaplasma Infections / Q000150:complications / Q000276:immunology*; D016990:Ureaplasma urealyticum; D014667:Vasopressins / Q000276:immunology
C438657:AVP protein, human; D001323:Autoantibodies; D009481:Neurophysins; D011498:Protein Precursors; D014667:Vasopressins