Arginine Vasopressin-Independent Mechanism of Impaired Water Excretion in a Patient with Sarcoidosis Complicated by Central Diabetes Insipidus and Glucocorticoid Deficiency
A 28-year-old man was admitted to our hospital because of reduced livido and increased fatigability. Four months before admission, he noticed polyuria, which was gradually relieved by admission. Magnetic resonance imaging revealed enhancing lesion centrally in the pituitary stalk. Biopsy from the sk...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2011-01-01
|
| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2011/145856 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850173195108220928 |
|---|---|
| author | Katsunobu Yoshioka Nagaaki Tanaka Keiko Yamagami Takeshi Inoue Masayuki Hosoi |
| author_facet | Katsunobu Yoshioka Nagaaki Tanaka Keiko Yamagami Takeshi Inoue Masayuki Hosoi |
| author_sort | Katsunobu Yoshioka |
| collection | DOAJ |
| description | A 28-year-old man was admitted to our hospital because of reduced livido and increased fatigability. Four months before admission, he noticed polyuria, which was gradually relieved by admission. Magnetic resonance imaging revealed enhancing lesion centrally in the pituitary stalk. Biopsy from the skin revealed noncaseating granuloma composed of epithelioid cells, and a diagnosis of sarcoidosis was made. Although plasma arginine vasopressin (AVP) was undetectable after administration of hypertonic saline, urinary output was within normal range (1.5 to 2.2 L/day). The urine osmolality became above plasma levels during the hypertonic saline test. Hormonal provocative tests revealed partial glucocorticoid deficiency. Soon after the glucocorticoid therapy was begun, moderate polyuria (from 3.5–4.0 liters daily) occurred. At this time, plasma AVP was undetectable, and urine osmolality was consistently below plasma levels during the hypertonic saline test. In conclusion, we showed in human study that masked diabetes insipidus could be mediated by AVP-independent mechanisms. |
| format | Article |
| id | doaj-art-d19d232abe1b4da1b85fa19c0a2ace10 |
| institution | OA Journals |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2011-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-d19d232abe1b4da1b85fa19c0a2ace102025-08-20T02:19:54ZengWileyCase Reports in Medicine1687-96271687-96352011-01-01201110.1155/2011/145856145856Arginine Vasopressin-Independent Mechanism of Impaired Water Excretion in a Patient with Sarcoidosis Complicated by Central Diabetes Insipidus and Glucocorticoid DeficiencyKatsunobu Yoshioka0Nagaaki Tanaka1Keiko Yamagami2Takeshi Inoue3Masayuki Hosoi4Department of Internal Medicine, Osaka City Sumiyoshi Hospital, 1-2-16, Higashikagaya, Suminoeku, Osaka City, Osaka 559-0012, JapanDepartment of Internal Medicine, Osaka City Juso Hospital, Osaka 532-0034, JapanDepartment of Endocrinology and Metabolism, Osaka City General Hospital, Osaka 534-0021, JapanDepartment of Pathology, Osaka City General Hospital, Osaka 534-0021, JapanDepartment of Endocrinology and Metabolism, Osaka City General Hospital, Osaka 534-0021, JapanA 28-year-old man was admitted to our hospital because of reduced livido and increased fatigability. Four months before admission, he noticed polyuria, which was gradually relieved by admission. Magnetic resonance imaging revealed enhancing lesion centrally in the pituitary stalk. Biopsy from the skin revealed noncaseating granuloma composed of epithelioid cells, and a diagnosis of sarcoidosis was made. Although plasma arginine vasopressin (AVP) was undetectable after administration of hypertonic saline, urinary output was within normal range (1.5 to 2.2 L/day). The urine osmolality became above plasma levels during the hypertonic saline test. Hormonal provocative tests revealed partial glucocorticoid deficiency. Soon after the glucocorticoid therapy was begun, moderate polyuria (from 3.5–4.0 liters daily) occurred. At this time, plasma AVP was undetectable, and urine osmolality was consistently below plasma levels during the hypertonic saline test. In conclusion, we showed in human study that masked diabetes insipidus could be mediated by AVP-independent mechanisms.http://dx.doi.org/10.1155/2011/145856 |
| spellingShingle | Katsunobu Yoshioka Nagaaki Tanaka Keiko Yamagami Takeshi Inoue Masayuki Hosoi Arginine Vasopressin-Independent Mechanism of Impaired Water Excretion in a Patient with Sarcoidosis Complicated by Central Diabetes Insipidus and Glucocorticoid Deficiency Case Reports in Medicine |
| title | Arginine Vasopressin-Independent Mechanism of Impaired Water Excretion in a Patient with Sarcoidosis Complicated by Central Diabetes Insipidus and Glucocorticoid Deficiency |
| title_full | Arginine Vasopressin-Independent Mechanism of Impaired Water Excretion in a Patient with Sarcoidosis Complicated by Central Diabetes Insipidus and Glucocorticoid Deficiency |
| title_fullStr | Arginine Vasopressin-Independent Mechanism of Impaired Water Excretion in a Patient with Sarcoidosis Complicated by Central Diabetes Insipidus and Glucocorticoid Deficiency |
| title_full_unstemmed | Arginine Vasopressin-Independent Mechanism of Impaired Water Excretion in a Patient with Sarcoidosis Complicated by Central Diabetes Insipidus and Glucocorticoid Deficiency |
| title_short | Arginine Vasopressin-Independent Mechanism of Impaired Water Excretion in a Patient with Sarcoidosis Complicated by Central Diabetes Insipidus and Glucocorticoid Deficiency |
| title_sort | arginine vasopressin independent mechanism of impaired water excretion in a patient with sarcoidosis complicated by central diabetes insipidus and glucocorticoid deficiency |
| url | http://dx.doi.org/10.1155/2011/145856 |
| work_keys_str_mv | AT katsunobuyoshioka argininevasopressinindependentmechanismofimpairedwaterexcretioninapatientwithsarcoidosiscomplicatedbycentraldiabetesinsipidusandglucocorticoiddeficiency AT nagaakitanaka argininevasopressinindependentmechanismofimpairedwaterexcretioninapatientwithsarcoidosiscomplicatedbycentraldiabetesinsipidusandglucocorticoiddeficiency AT keikoyamagami argininevasopressinindependentmechanismofimpairedwaterexcretioninapatientwithsarcoidosiscomplicatedbycentraldiabetesinsipidusandglucocorticoiddeficiency AT takeshiinoue argininevasopressinindependentmechanismofimpairedwaterexcretioninapatientwithsarcoidosiscomplicatedbycentraldiabetesinsipidusandglucocorticoiddeficiency AT masayukihosoi argininevasopressinindependentmechanismofimpairedwaterexcretioninapatientwithsarcoidosiscomplicatedbycentraldiabetesinsipidusandglucocorticoiddeficiency |