A case of central diabetes insipidus after COVID-19 as a probable diagnosis of lymphocytic infundibulo-neurohypophysitis with positive anti-rabphilin-3A antibodies with review of literature
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2, and various complications have been reported. Furthermore, there have been increasing reports of endocrinopathy related to COVID-19 following the pandemic. We report a 49-year-old healthy woman who deve...
Saved in:
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
The Japan Endocrine Society
2024-12-01
|
| Series: | Endocrine Journal |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/endocrj/71/12/71_EJ24-0093/_html/-char/en |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832591924371914752 |
|---|---|
| author | Yuka Natsuki Yuki Nagata Toshiki Nagasaki Mari Morimoto Norikazu Toi Masafumi Kurajoh Tomoaki Morioka Tetsuo Shoji Yasuo Imanishi Naoko Iwata Haruki Fujisawa Atsushi Suzuki Yoshihisa Sugimura Masanori Emoto |
| author_facet | Yuka Natsuki Yuki Nagata Toshiki Nagasaki Mari Morimoto Norikazu Toi Masafumi Kurajoh Tomoaki Morioka Tetsuo Shoji Yasuo Imanishi Naoko Iwata Haruki Fujisawa Atsushi Suzuki Yoshihisa Sugimura Masanori Emoto |
| author_sort | Yuka Natsuki |
| collection | DOAJ |
| description | Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2, and various complications have been reported. Furthermore, there have been increasing reports of endocrinopathy related to COVID-19 following the pandemic. We report a 49-year-old healthy woman who developed rapid onset of polydipsia and polyuria three weeks after COVID-19. Laboratory tests indicated low urine osmolarity and increased serum osmolarity, and antidiuretic hormone (ADH) was undetectable. Urine osmolality remained low with water deprivation. Similarly, plasma ADH responses to hypertonic-saline infusion were blunted and urine osmolality increased in response to desmopressin. There was no clear evidence of anterior pituitary dysfunction. T1-weighted magnetic resonance imaging (MRI) showed pituitary stalk thickening and absence of posterior pituitary bright signal spots, suggesting the presence of hypophysitis. Based on these results, we made a probable diagnosis of lymphocytic infundibulo-neurohypophysitis (LINH) which have caused central diabetes insipidus. Positive findings for serum anti-rabphilin-3A antibodies, reported as a potential diagnostic marker for LINH, were also noted. Following oral desmopressin administration, polydipsia and polyuria were quickly improved, though treatment with desmopressin was still required over four months. This is the first report of a patient with a probable diagnosis of LINH after COVID-19 who tested positive for anti-rabphilin-3A antibodies. Positive findings for those antibodies suggest that pituitary dysfunction associated with COVID-19 is hypophysitis involving an abnormal immune mechanism. The presence of anti-rabphilin-3A antibodies may be useful as a non-invasive diagnostic marker of LINH and potentially serve as a valuable diagnostic aid in cases of LINH associated with COVID-19. |
| format | Article |
| id | doaj-art-a2ba444135664653839d77f315f19fde |
| institution | Kabale University |
| issn | 1348-4540 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | The Japan Endocrine Society |
| record_format | Article |
| series | Endocrine Journal |
| spelling | doaj-art-a2ba444135664653839d77f315f19fde2025-01-22T05:34:07ZengThe Japan Endocrine SocietyEndocrine Journal1348-45402024-12-0171121165117310.1507/endocrj.EJ24-0093endocrjA case of central diabetes insipidus after COVID-19 as a probable diagnosis of lymphocytic infundibulo-neurohypophysitis with positive anti-rabphilin-3A antibodies with review of literatureYuka Natsuki0Yuki Nagata1Toshiki Nagasaki2Mari Morimoto3Norikazu Toi4Masafumi Kurajoh5Tomoaki Morioka6Tetsuo Shoji7Yasuo Imanishi8Naoko Iwata9Haruki Fujisawa10Atsushi Suzuki11Yoshihisa Sugimura12Masanori Emoto13Department of Metabolism, Endocrinology and Molecular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, JapanDepartment of Vascular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, JapanNagasaki Thyroid Clinic, Osaka 546-0014, JapanDepartment of Metabolism, Endocrinology and Molecular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, JapanDepartment of Metabolism, Endocrinology and Molecular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, JapanDepartment of Metabolism, Endocrinology and Molecular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, JapanDepartment of Metabolism, Endocrinology and Molecular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, JapanDepartment of Vascular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, JapanDepartment of Metabolism, Endocrinology and Molecular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, JapanDepartment of Endocrinology, Diabetes and Metabolism, Fujita Health University School of Medicine, Aichi 470-1192, JapanDepartment of Endocrinology, Diabetes and Metabolism, Fujita Health University School of Medicine, Aichi 470-1192, JapanDepartment of Endocrinology, Diabetes and Metabolism, Fujita Health University School of Medicine, Aichi 470-1192, JapanDepartment of Endocrinology, Diabetes and Metabolism, Fujita Health University School of Medicine, Aichi 470-1192, JapanDepartment of Metabolism, Endocrinology and Molecular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, JapanCoronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2, and various complications have been reported. Furthermore, there have been increasing reports of endocrinopathy related to COVID-19 following the pandemic. We report a 49-year-old healthy woman who developed rapid onset of polydipsia and polyuria three weeks after COVID-19. Laboratory tests indicated low urine osmolarity and increased serum osmolarity, and antidiuretic hormone (ADH) was undetectable. Urine osmolality remained low with water deprivation. Similarly, plasma ADH responses to hypertonic-saline infusion were blunted and urine osmolality increased in response to desmopressin. There was no clear evidence of anterior pituitary dysfunction. T1-weighted magnetic resonance imaging (MRI) showed pituitary stalk thickening and absence of posterior pituitary bright signal spots, suggesting the presence of hypophysitis. Based on these results, we made a probable diagnosis of lymphocytic infundibulo-neurohypophysitis (LINH) which have caused central diabetes insipidus. Positive findings for serum anti-rabphilin-3A antibodies, reported as a potential diagnostic marker for LINH, were also noted. Following oral desmopressin administration, polydipsia and polyuria were quickly improved, though treatment with desmopressin was still required over four months. This is the first report of a patient with a probable diagnosis of LINH after COVID-19 who tested positive for anti-rabphilin-3A antibodies. Positive findings for those antibodies suggest that pituitary dysfunction associated with COVID-19 is hypophysitis involving an abnormal immune mechanism. The presence of anti-rabphilin-3A antibodies may be useful as a non-invasive diagnostic marker of LINH and potentially serve as a valuable diagnostic aid in cases of LINH associated with COVID-19.https://www.jstage.jst.go.jp/article/endocrj/71/12/71_EJ24-0093/_html/-char/encoronavirus disease 2019 (covid-19)lymphocytic infundibulo-neurohypophysitiscentral diabetes insipidusanti-rabphilin-3a antibodies |
| spellingShingle | Yuka Natsuki Yuki Nagata Toshiki Nagasaki Mari Morimoto Norikazu Toi Masafumi Kurajoh Tomoaki Morioka Tetsuo Shoji Yasuo Imanishi Naoko Iwata Haruki Fujisawa Atsushi Suzuki Yoshihisa Sugimura Masanori Emoto A case of central diabetes insipidus after COVID-19 as a probable diagnosis of lymphocytic infundibulo-neurohypophysitis with positive anti-rabphilin-3A antibodies with review of literature Endocrine Journal coronavirus disease 2019 (covid-19) lymphocytic infundibulo-neurohypophysitis central diabetes insipidus anti-rabphilin-3a antibodies |
| title | A case of central diabetes insipidus after COVID-19 as a probable diagnosis of lymphocytic infundibulo-neurohypophysitis with positive anti-rabphilin-3A antibodies with review of literature |
| title_full | A case of central diabetes insipidus after COVID-19 as a probable diagnosis of lymphocytic infundibulo-neurohypophysitis with positive anti-rabphilin-3A antibodies with review of literature |
| title_fullStr | A case of central diabetes insipidus after COVID-19 as a probable diagnosis of lymphocytic infundibulo-neurohypophysitis with positive anti-rabphilin-3A antibodies with review of literature |
| title_full_unstemmed | A case of central diabetes insipidus after COVID-19 as a probable diagnosis of lymphocytic infundibulo-neurohypophysitis with positive anti-rabphilin-3A antibodies with review of literature |
| title_short | A case of central diabetes insipidus after COVID-19 as a probable diagnosis of lymphocytic infundibulo-neurohypophysitis with positive anti-rabphilin-3A antibodies with review of literature |
| title_sort | case of central diabetes insipidus after covid 19 as a probable diagnosis of lymphocytic infundibulo neurohypophysitis with positive anti rabphilin 3a antibodies with review of literature |
| topic | coronavirus disease 2019 (covid-19) lymphocytic infundibulo-neurohypophysitis central diabetes insipidus anti-rabphilin-3a antibodies |
| url | https://www.jstage.jst.go.jp/article/endocrj/71/12/71_EJ24-0093/_html/-char/en |
| work_keys_str_mv | AT yukanatsuki acaseofcentraldiabetesinsipidusaftercovid19asaprobablediagnosisoflymphocyticinfundibuloneurohypophysitiswithpositiveantirabphilin3aantibodieswithreviewofliterature AT yukinagata acaseofcentraldiabetesinsipidusaftercovid19asaprobablediagnosisoflymphocyticinfundibuloneurohypophysitiswithpositiveantirabphilin3aantibodieswithreviewofliterature AT toshikinagasaki acaseofcentraldiabetesinsipidusaftercovid19asaprobablediagnosisoflymphocyticinfundibuloneurohypophysitiswithpositiveantirabphilin3aantibodieswithreviewofliterature AT marimorimoto acaseofcentraldiabetesinsipidusaftercovid19asaprobablediagnosisoflymphocyticinfundibuloneurohypophysitiswithpositiveantirabphilin3aantibodieswithreviewofliterature AT norikazutoi acaseofcentraldiabetesinsipidusaftercovid19asaprobablediagnosisoflymphocyticinfundibuloneurohypophysitiswithpositiveantirabphilin3aantibodieswithreviewofliterature AT masafumikurajoh acaseofcentraldiabetesinsipidusaftercovid19asaprobablediagnosisoflymphocyticinfundibuloneurohypophysitiswithpositiveantirabphilin3aantibodieswithreviewofliterature AT tomoakimorioka acaseofcentraldiabetesinsipidusaftercovid19asaprobablediagnosisoflymphocyticinfundibuloneurohypophysitiswithpositiveantirabphilin3aantibodieswithreviewofliterature AT tetsuoshoji acaseofcentraldiabetesinsipidusaftercovid19asaprobablediagnosisoflymphocyticinfundibuloneurohypophysitiswithpositiveantirabphilin3aantibodieswithreviewofliterature AT yasuoimanishi acaseofcentraldiabetesinsipidusaftercovid19asaprobablediagnosisoflymphocyticinfundibuloneurohypophysitiswithpositiveantirabphilin3aantibodieswithreviewofliterature AT naokoiwata acaseofcentraldiabetesinsipidusaftercovid19asaprobablediagnosisoflymphocyticinfundibuloneurohypophysitiswithpositiveantirabphilin3aantibodieswithreviewofliterature AT harukifujisawa acaseofcentraldiabetesinsipidusaftercovid19asaprobablediagnosisoflymphocyticinfundibuloneurohypophysitiswithpositiveantirabphilin3aantibodieswithreviewofliterature AT atsushisuzuki acaseofcentraldiabetesinsipidusaftercovid19asaprobablediagnosisoflymphocyticinfundibuloneurohypophysitiswithpositiveantirabphilin3aantibodieswithreviewofliterature AT yoshihisasugimura acaseofcentraldiabetesinsipidusaftercovid19asaprobablediagnosisoflymphocyticinfundibuloneurohypophysitiswithpositiveantirabphilin3aantibodieswithreviewofliterature AT masanoriemoto acaseofcentraldiabetesinsipidusaftercovid19asaprobablediagnosisoflymphocyticinfundibuloneurohypophysitiswithpositiveantirabphilin3aantibodieswithreviewofliterature AT yukanatsuki caseofcentraldiabetesinsipidusaftercovid19asaprobablediagnosisoflymphocyticinfundibuloneurohypophysitiswithpositiveantirabphilin3aantibodieswithreviewofliterature AT yukinagata caseofcentraldiabetesinsipidusaftercovid19asaprobablediagnosisoflymphocyticinfundibuloneurohypophysitiswithpositiveantirabphilin3aantibodieswithreviewofliterature AT toshikinagasaki caseofcentraldiabetesinsipidusaftercovid19asaprobablediagnosisoflymphocyticinfundibuloneurohypophysitiswithpositiveantirabphilin3aantibodieswithreviewofliterature AT marimorimoto caseofcentraldiabetesinsipidusaftercovid19asaprobablediagnosisoflymphocyticinfundibuloneurohypophysitiswithpositiveantirabphilin3aantibodieswithreviewofliterature AT norikazutoi caseofcentraldiabetesinsipidusaftercovid19asaprobablediagnosisoflymphocyticinfundibuloneurohypophysitiswithpositiveantirabphilin3aantibodieswithreviewofliterature AT masafumikurajoh caseofcentraldiabetesinsipidusaftercovid19asaprobablediagnosisoflymphocyticinfundibuloneurohypophysitiswithpositiveantirabphilin3aantibodieswithreviewofliterature AT tomoakimorioka caseofcentraldiabetesinsipidusaftercovid19asaprobablediagnosisoflymphocyticinfundibuloneurohypophysitiswithpositiveantirabphilin3aantibodieswithreviewofliterature AT tetsuoshoji caseofcentraldiabetesinsipidusaftercovid19asaprobablediagnosisoflymphocyticinfundibuloneurohypophysitiswithpositiveantirabphilin3aantibodieswithreviewofliterature AT yasuoimanishi caseofcentraldiabetesinsipidusaftercovid19asaprobablediagnosisoflymphocyticinfundibuloneurohypophysitiswithpositiveantirabphilin3aantibodieswithreviewofliterature AT naokoiwata caseofcentraldiabetesinsipidusaftercovid19asaprobablediagnosisoflymphocyticinfundibuloneurohypophysitiswithpositiveantirabphilin3aantibodieswithreviewofliterature AT harukifujisawa caseofcentraldiabetesinsipidusaftercovid19asaprobablediagnosisoflymphocyticinfundibuloneurohypophysitiswithpositiveantirabphilin3aantibodieswithreviewofliterature AT atsushisuzuki caseofcentraldiabetesinsipidusaftercovid19asaprobablediagnosisoflymphocyticinfundibuloneurohypophysitiswithpositiveantirabphilin3aantibodieswithreviewofliterature AT yoshihisasugimura caseofcentraldiabetesinsipidusaftercovid19asaprobablediagnosisoflymphocyticinfundibuloneurohypophysitiswithpositiveantirabphilin3aantibodieswithreviewofliterature AT masanoriemoto caseofcentraldiabetesinsipidusaftercovid19asaprobablediagnosisoflymphocyticinfundibuloneurohypophysitiswithpositiveantirabphilin3aantibodieswithreviewofliterature |