A case of revealed central diabetes insipidus during pregnancy after previous traumatic central diabetes insipidus

Abstract

 A 35-year-old primipara at her 30th week of gestation presented with polydipsia and polyuria. When she was 17 years old, she had a medical history of traumatic central diabetes insipidus, cured in a month with desmopressin（dDAVP）. She was diagnosed with gestational diabetes mellitus at 26 weeks of gestation. At 35 weeks of gestation, she was referred to our hospital for a medical examination. Laboratory data showed low arginine vasopressin and urine osmolality. At 36 weeks of gestation, after she was administered nasal dDAVP, her urine volume decreased and urine osmolality elevated rapidly. She was diagnosed to have central diabetes insipidus. Although fetal growth was normal, amniotic fluid deficiency was observed. A healthy baby was delivered via spontaneous vaginal delivery at 39 weeks and four days. The patient’s symptoms did not recur despite the tapering and termination of dDAVP administration after birth.

 In this case, the subclinical deficiency of AVP or insufficiency of additional AVP due to past trauma was thought to have caused the manifestation of central diabetes insipidus.