Acute diabetes insipidus mediated by vasopressinase after placental abruption.

Details

Serval ID
serval:BIB_1ADB55019429
Type
Article: article from journal or magazin.
Collection
Publications
Title
Acute diabetes insipidus mediated by vasopressinase after placental abruption.
Journal
The Journal of clinical endocrinology and metabolism
Author(s)
Wallia A., Bizhanova A., Huang W., Goldsmith S.L., Gossett D.R., Kopp P.
ISSN
1945-7197 (Electronic)
ISSN-L
0021-972X
Publication state
Published
Issued date
03/2013
Peer-reviewed
Oui
Volume
98
Number
3
Pages
881-886
Language
english
Notes
Publication types: Case Reports ; Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Postpartum, diabetes insipidus (DI) can be part of Sheehan's syndrome or lymphocytic hypophysitis in combination with anterior pituitary hormone deficiencies. In contrast, acute onset of isolated DI in the postpartum period is unusual.
This patient presented at 33 weeks gestation with placental abruption, prompting a cesarean delivery of twins. Immediately after delivery, she developed severe DI. The DI could be controlled with the vasopressinase-resistant 1-deamino-8-D-arginine vasopressin (DDAVP), but not with arginine vasopressin (AVP), and it resolved within a few weeks.
The aim of this study was to demonstrate that the postpartum DI in this patient was caused by the release of placental vasopressinase into the maternal bloodstream.
Cells were transiently transfected with the AVP receptor 2 (AVPR2) and treated with either AVP or DDAVP in the presence of the patient's serum collected postpartum or 10 weeks after delivery. The response to the different treatments was evaluated by measuring the activity of a cAMP-responsive firefly luciferase reporter construct. The in vitro studies demonstrate that the patient's postpartum serum disrupts activation of the AVPR2 by AVP, but not by the vasopressinase-resistant DDAVP.
Placental abruption can rarely be associated with acute postpartum DI caused by release of placental vasopressinase into the bloodstream. This clinical entity must be considered in patients with placental abruption and when evaluating patients presenting with DI after delivery.
Keywords
Abruptio Placentae/blood, Abruptio Placentae/physiopathology, Acute Disease, Adult, Antidiuretic Agents/administration & dosage, Arginine Vasopressin/administration & dosage, Cesarean Section, Cystinyl Aminopeptidase/blood, Deamino Arginine Vasopressin/administration & dosage, Diabetes Insipidus/blood, Diabetes Insipidus/drug therapy, Diabetes Insipidus/etiology, Drug Resistance, Female, HEK293 Cells, Humans, Postpartum Period/blood, Postpartum Period/drug effects, Pregnancy
Pubmed
Web of science
Open Access
Yes
Create date
27/12/2020 23:00
Last modification date
28/12/2020 6:26
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