title: Exacerbation of pre-existing diabetes insipidus during pregnancy, mechanisms and management.
abstract: During pregnancy, physiological changes in osmotic homeostasis cause water retention. If excessive, this can cause gestational diabetes insipidus (DI), particularly in patients with already impaired vasopressin secretion. We present the case of a 34-year-old patient with pre-existing hypopituitarism who experienced a transient exacerbation of her DI during a twin pregnancy. In contrast to typical gestational DI, polyuria and polydipsia occurred during the first trimester and remained stable thereafter. This case highlights a challenging clinical entity of which pathophysiology, diagnostic approach and treatment will be discussed.
authors.affiliation: a Division of Pediatric Endocrinology, Department of Pediatrics , Ghent University Hospital, Ghent University , Ghent , Belgium.
authors.forename: Lloyd J W
authors.initials: LJW
authors.lastname: Tack
authors.affiliation: b Division of Endocrinology, Department Internal Medicine , Ghent University Hospital, Ghent University , Ghent , Belgium.
authors.forename: Guy
authors.initials: G
authors.lastname: T'Sjoen
authors.affiliation: b Division of Endocrinology, Department Internal Medicine , Ghent University Hospital, Ghent University , Ghent , Belgium.
authors.forename: Bruno
authors.initials: B
authors.lastname: Lapauw
mesh_terms: D000236:Adenoma / Q000601:surgery; D000328:Adult; D050034:Antidiuretic Agents / Q000627:therapeutic use*; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use*; D003919:Diabetes Insipidus / Q000188:drug therapy* / Q000209:etiology; D018450:Disease Progression; D005260:Female; D006801:Humans; D007018:Hypopituitarism / Q000150:complications; D010911:Pituitary Neoplasms / Q000601:surgery; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000209:etiology; D011261:Pregnancy Trimester, First; D059285:Pregnancy, Twin
chemical_list: D050034:Antidiuretic Agents; D003894:Deamino Arginine Vasopressin
keywords: Diabetes insipidus; Gestational diabetes insipidus; Hypopituitarism; Pregnancy; dDAVP