Electrolyte Blood Press.  2017 Sep;15(1):23-25. 10.5049/EBP.2017.15.1.23.

Central Diabetes Insipidus Linked to Rathke's Cleft Cyst, Polyuria in a 17-year-old Girl

• Kim HY
• Lee SJ
• Bae EH
• Ma SK
• Kim SW

• KMID: 2391009
• DOI: http://doi.org/10.5049/EBP.2017.15.1.23

Abstract

A 17-year-old girl presented with polyuria (7 L/day) and polydipsia for one year. Initial urine osmolality was 113mOsm/kg Hâ‚‚O. Following 6 h of fluid restriction, serum plasma osmolality reached 300mOsm/kg Hâ‚‚O, whereas urine osmolality was 108mOsm/kg Hâ‚‚O. Urine osmolality was increased by 427% from 108 to 557mOsm/kg after vasopressin challenge. The patient was diagnosed with central diabetes insipidus, possibly derived from the atypical occupation of a Rathke's cleft cyst at the pituitary stalk following magnetic resonance imaging with enhancement. She was discharged with desmopressin nasal spray (10 µg); urine output was maintained at 2-3 L/day, and urine osmolality was >300 mOsm/kg. Additional pituitary image studies and evaluation of hypopituitarism should be included in the differential diagnosis of patients with central diabetes insipidus.

Keyword

Central diabetes insipidus; Rathke's cleft cyst; Polyuria

MeSH Terms

Adolescent*
Deamino Arginine Vasopressin
Diabetes Insipidus, Neurogenic*
Diagnosis, Differential
Female*
Humans
Hypopituitarism
Magnetic Resonance Imaging
Occupations
Osmolar Concentration
Pituitary Gland
Plasma
Polydipsia
Polyuria*
Vasopressins
Deamino Arginine Vasopressin
Vasopressins

Figure

• 

  Fig. 1 (A) Water deprivation and arginine vasopressin challenge test; (B, C) Sagittal T1-weighted magnetic resonance (MR) image shows well-defined hypersignal intensity sellar lesion (B), without enhancing portion on gadolinium-enhanced fat-suppressed T1-weighted image (C).

Reference

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