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

Tsunehiko YAMAMOTO; Tomofusa ISHII; Katsunobu YOSHIOKA; Keiko YAMAGAMI; Tetsuya YAMAKITA; Masashi MIYAMOTO; Masayuki HOSOI; Toshihiko SATO; Shiro TANAKA; Satoru FUJII

doi:10.2169/internalmedicine.42.513

Tsunehiko YAMAMOTO, Tomofusa ISHII, Katsunobu YOSHIOKA, Keiko YAMAGAMI, Tetsuya YAMAKITA, Masashi MIYAMOTO, Masayuki HOSOI, Toshihiko SATO, Shiro TANAKA, Satoru FUJII

Author information

Tsunehiko YAMAMOTO
The Department of Metabolism and Endocrinology, Osaka City General Hospital
Tomofusa ISHII
The Department of Metabolism and Endocrinology, Osaka City General Hospital
Katsunobu YOSHIOKA
The Department of Metabolism and Endocrinology, Osaka City General Hospital
Keiko YAMAGAMI
The Department of Metabolism and Endocrinology, Osaka City General Hospital
Tetsuya YAMAKITA
The Department of Metabolism and Endocrinology, Osaka City General Hospital
Masashi MIYAMOTO
The Department of Metabolism and Endocrinology, Osaka City General Hospital
Masayuki HOSOI
The Department of Metabolism and Endocrinology, Osaka City General Hospital
Toshihiko SATO
The Department of Metabolism and Endocrinology, Osaka City General Hospital
Shiro TANAKA
The Department of Metabolism and Endocrinology, Osaka City General Hospital
Satoru FUJII
The Department of Metabolism and Endocrinology, Osaka City General Hospital

Keywords: diabetes insipidus, pregnancy, posterior pituitary lobe, hyperintense signal, depletion-repletion process

JOURNAL FREE ACCESS

2003 Volume 42 Issue 6 Pages 513-516

DOI https://doi.org/10.2169/internalmedicine.42.513

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Abstract

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)

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