Transient Central Diabetes Insipidus in Pregnancy with a Peculiar Change in Signal Intensity on T1-Weighted Magnetic Resonance Images

• Published in: Internal Medicine Vol. 42; no. 6; pp. 513 - 516
• Main Authors: YAMAMOTO, Tsunehiko, ISHII, Tomofusa, YOSHIOKA, Katsunobu, YAMAGAMI, Keiko, YAMAKITA, Tetsuya, MIYAMOTO, Masashi, HOSOI, Masayuki, SATO, Toshihiko, TANAKA, Shiro, FUJII, Satoru
• Format: Journal Article
• Language: English
• Published: Tokyo The Japanese Society of Internal Medicine 01.06.2003; Japanese Society of Internal Medicine
• Subjects: Adult; Biological and medical sciences; depletion-repletion process; diabetes insipidus; Diabetes Insipidus, Neurogenic - diagnosis; Diabetes. Impaired glucose tolerance; Diseases of mother, fetus and pregnancy; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Humans; hyperintense signal; Hyperplasia - metabolism; Hyperplasia - pathology; Magnetic Resonance Imaging; Medical sciences; Pituitary Gland, Posterior - metabolism; Pituitary Gland, Posterior - pathology; posterior pituitary lobe; Pregnancy; Pregnancy Complications - diagnosis; Pregnancy Outcome; Pregnancy Trimester, Third; Pregnancy. Fetus. Placenta; Remission, Spontaneous; Risk Assessment; Vasopressins - blood; Endocrinopathy; Pregnancy; Human; diabetes insipidus; Diabetes mellitus; hyperintense signal; depletion-repletion process; Medical imagery; posterior pituitary lobe; Diagnosis; Nuclear magnetic resonance imaging
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.42.513

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. (Internal Medicine 42: 513-516, 2003)