Choi Hong Sang, Kim Yoon Ha, Kim Chang Seong, Ma Seong Kwon, Kim Soo Wan, Bae Eun Hui
Department of Internal Medicine, Chonnam National University Medical School.
Department of Obstetrics and Gynecology, Chonnam National University Medical School.
J Nippon Med Sch. 2018;85(3):191-193. doi: 10.1272/jnms.JNMS.2018_85-29.
We report a case of subclinical central diabetes insipidus (DI), due to Rathke's cleft cysts, that was initially misdiagnosed as transient DI of pregnancy because it presented in the third trimester of pregnancy. A 37-year-old primigravida visited the Department of Obstetrics in the 30th week of gestation due to polyuria. She was admitted due to oligohydramnios; the amniotic fluid index was 3.24. A vasopressin challenge test was performed and her urine osmolality increased by >100% from baseline after the administration of desmopressin. Because central DI or transient DI of pregnancy was suspected, we prescribed her a desmopressin nasal spray. She gave birth to a relatively healthy baby at 37 weeks and 4 days of gestation. Several months after delivery, discontinuation of desmopressin resulted in recurrence of her polyuria. Magnetic resonance imaging of her brain revealed Rathke's cleft cysts, and finally central DI was diagnosed.
我们报告一例因拉克氏裂囊肿导致的亚临床中枢性尿崩症（DI），该病例最初被误诊为妊娠一过性DI，因为其在妊娠晚期出现。一名37岁初产妇因多尿于妊娠30周时就诊于产科。她因羊水过少入院；羊水指数为3.24。进行了血管加压素激发试验，给予去氨加压素后，她的尿渗透压较基线升高超过100%。由于怀疑是中枢性DI或妊娠一过性DI，我们给她开了去氨加压素鼻喷雾剂。她在妊娠37周零4天时生下一个相对健康的婴儿。分娩后几个月，停用去氨加压素导致她再次出现多尿。脑部磁共振成像显示拉克氏裂囊肿，最终诊断为中枢性DI。
