Morrone L F, Saracino A, Ramunni A, Fasianos E, Coratelli P, Passavanti G
Department of Internal and Public Medicine, Division of Nephrology, Polyclinic, University of Bari, Italy.
Clin Nephrol. 2003 Dec;60(6):433-6. doi: 10.5414/cnp60433.
Central diabetes insipidus (CDI) arising in the puerperal period has been attributed mainly to Sheehan's syndrome or to lymphocytic infundibulo-neurohypophysitis. We report the case of a 24-year-old woman who came to our observation for the appearance, 3 weeks after a normal delivery, of a polyuric-polydipsic syndrome. Measurements of urinary volumes, plasma osmolality and urinary osmolality, in conditions of free water intake, water deprivation and a water deprivation-vasopressin administration test, demonstrated CDI. Brain magnetic resonance imaging showed a normal morphology of the adenohypophysis and total absence of the neurohypophysis. Assays of the pituitary hormones were found to be within normal limits. These results, incompatible with a diagnosis of Sheehan's syndrome and lymphocytic infundibulo-neurohypophysis, excluded all the other known causes of acquired CDI. Our diagnosis was therefore of post-gravid idiopathic CDI. Thus, it is possible that in the puerperal period other diseases of the posterior hypophysis may develop, of unknown etiopathogenesis but equally responsible for CDI.
产后发生的中枢性尿崩症（CDI）主要归因于席汉综合征或淋巴细胞性漏斗神经垂体炎。我们报告了一例24岁女性的病例，该女性在正常分娩3周后出现多尿多饮综合征，前来我院就诊。在自由饮水、禁水及禁水 - 血管加压素给药试验条件下，对尿量、血浆渗透压和尿渗透压进行测量，证实为CDI。脑部磁共振成像显示腺垂体形态正常，神经垂体完全缺如。垂体激素检测结果在正常范围内。这些结果与席汉综合征和淋巴细胞性漏斗神经垂体炎的诊断不相符，排除了获得性CDI的所有其他已知病因。因此，我们的诊断是产后特发性CDI。因此，在产褥期可能会发生其他垂体后叶疾病，其病因不明，但同样可导致CDI。
