Pregnant Woman with Transient Diabetes insipidus Resistant to 1-Desamino-8-D-Arginine Vasopressin

• Published in: Endocrine Journal Vol. 45; no. 5; pp. 693 - 696
• Main Authors: JIN-NO, YASUNARI, KAMIYA, YOSHINOBU, OKADA, MASAMI, WATANABE, OSAMU, OGASAWARA, MAYUMI, FUJINAMI, TAKAO
• Format: Journal Article
• Language: English
• Published: Japan The Japan Endocrine Society 01.10.1998
• Subjects: Adult; Deamino Arginine Vasopressin - therapeutic use; Diabetes insipidus; Diabetes Insipidus - blood; Diabetes Insipidus - drug therapy; Diabetes Insipidus - urine; Female; Humans; Hydronephrosis; Magnetic Resonance Imaging; Pituitary Gland - pathology; Pregnancy; Pregnancy in Diabetics - blood; Pregnancy in Diabetics - drug therapy; Pregnancy in Diabetics - urine; Pregnancy Outcome; Pregnancy Trimester, Third; Prostaglandin; Renal Agents - therapeutic use; Treatment Outcome
• ISSN: 0918-8959; 1348-4540
• DOI: 10.1507/endocrj.45.693

We encountered a pregnant woman with transient diabetes insipidus which developed during the third trimester. A hypertonic saline infusion study did not concentrate the osmolality of urine. Her laboratory data showed hypokalemia, hyperreninemia, an increased concentration of plasma aldosterone and an increased urinary excretion rate of prostaglandin E2, which resembled hyperprostaglandin E-syndrome. T1-weighted magnetic resonance imaging of the posterior pituitary gland revealed decreased intensity. Polyuria reached 4-6 L daily, and urine osmolality remained dilute despite a lapse of four days since treatment with intranasal 1-desamino-8-D-arginine vasopressin (dDAVP: 10-25μg every 12 h). The patient was conservatively managed without medical treatment, then delivered in the 38th week of pregnancy without complication. The osmolality of the patient's urine was higher than that of the plasma when tested 3 days postpartum. The abnormality of magnetic resonance imaging of the posterior pituitary gland disappeared at 6 months after delivery. We consider that subclinical nephrogenic diabetes insipidus in our patient was exacerbated during pregnancy.