Manifestation of subclinical diabetes insipidus due to pituitary tumor during pregnancy

Endocr J. 1996 Oct;43(5):577-83. doi: 10.1507/endocrj.43.577.

Abstract

We describe a case of diabetes insipidus (DI) due to a pituitary tumor in a 33-year-old pregnant woman who developed a sudden onset of polyuria (over 8 l/day) and polydipsia at 30 weeks of gestation. Her plasma concentration of vasopressin (AVP) was low compared with high serum osmolality (298 mOsm/kg), and her urine output was well controlled by treatment with desmopressin acetate (DDAVP). Cranial magnetic resonance imaging (MRI) demonstrated a 1.8 x 1.2-cm pituitary tumor, but she did not have any disturbance in the release of anterior pituitary hormones. The serum concentration of cystine aminopeptidase (CAP) was within the normal range for a woman at 34 weeks of gestation. After an uncomplicated delivery of a healthy girl, her polyuria gradually resolved. The size of the pituitary tumor gradually decreased in parallel to a reduction in her urine output, but a silent hemorrhage was detected in her pituitary gland 4 weeks after the delivery. Although pregnancy is sometimes associated with central DI, the occurrence of DI due to pituitary tumor under pregnancy is rare. The basal AVP recovered to within the normal range, but the low response of AVP secretion to high osmolality persisted. In this case, pregnancy may affect the manifestation of subclinical DI. This case may therefore enhance our understanding of the mechanisms of DI during pregnancy.

Publication types

  • Case Reports

MeSH terms

  • Adenoma / complications*
  • Adenoma / diagnosis
  • Adult
  • Body Weight / drug effects
  • Body Weight / physiology
  • Deamino Arginine Vasopressin / pharmacology
  • Deamino Arginine Vasopressin / therapeutic use*
  • Diabetes Insipidus / diagnosis*
  • Diabetes Insipidus / drug therapy
  • Diabetes Insipidus / etiology
  • Female
  • Humans
  • Hypoglycemic Agents / pharmacology
  • Hypoglycemic Agents / therapeutic use*
  • Magnetic Resonance Imaging
  • Osmolar Concentration
  • Pituitary Function Tests
  • Pituitary Gland, Anterior / physiology
  • Pituitary Neoplasms / complications*
  • Pituitary Neoplasms / diagnosis
  • Pregnancy
  • Pregnancy Complications / diagnosis*
  • Pregnancy Complications / drug therapy
  • Pregnancy Complications / etiology
  • Pregnancy Complications, Neoplastic / diagnosis
  • Pregnancy Trimester, Third
  • Time Factors
  • Urine / chemistry
  • Urine / physiology
  • Vasopressins / blood
  • Vasopressins / drug effects
  • Vasopressins / metabolism

Substances

  • Hypoglycemic Agents
  • Vasopressins
  • Deamino Arginine Vasopressin