Exacerbation of pre-existing diabetes insipidus during pregnancy, mechanisms and management

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...

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Bibliographic Details
Published in:Acta clinica belgica (English ed. Online) 2017-06, Vol.72 (3), p.213-216
Main Authors: Tack, Lloyd J.W., T'Sjoen, Guy, Lapauw, Bruno
Format: Article
Language:English
Subjects:
Adenoma - surgery
Adult
Antidiuretic Agents - therapeutic use
dDAVP
Deamino Arginine Vasopressin - therapeutic use
Diabetes
Diabetes insipidus
Diabetes Insipidus - drug therapy
Diabetes Insipidus - etiology
Disease Progression
Female
Gestational diabetes insipidus
Humans
Hypopituitarism
Hypopituitarism - complications
Pituitary Neoplasms - surgery
Pregnancy
Pregnancy Complications - drug therapy
Pregnancy Complications - etiology
Pregnancy Trimester, First
Pregnancy, Twin
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Summary: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.
ISSN:1784-3286
2295-3337
DOI:10.1080/17843286.2016.1235244