A case of systemic lupus erythematosus manifested diabetes insipidus

Abstract

A 32-year-old-female with systemic lupus erythematosus (SLE) suddenly manifested signs of diabetes insipidus shortly after she had been placed on a high-dose prednisolone for high fever, hemorrhagic tendency, mental confusion and motor neuron abnormalities. Psychogenic polydipsia was excluded on the basis of progressive polyuria in the presence of dehydration. Tobramycin-induced tubular dysfunction was denied because of the extreme severity of polyuria, negative urinary findings and a negative rechallenge study.
Diabetes insipidus is a rare manifestation of SLE. Vasculitis of small arteries may have been responsible for reversible ischemic changes in the hypothalamus-pituitary axis in this case.