The clinical course and pathophysiological investigation of adolescent gestational diabetes insipidus: a case report

BACKGROUND: Gestational diabetes insipidus (GDI) is a rare endocrine complication during pregnancy that is associated with vasopressinase overproduction from the placenta. Although increased vasopressinase is associated with placental volume, the regulation of placental growth in the later stage of...

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Autores principales: Kondo, Tatsuya, Nakamura, Miwa, Kitano, Sayaka, Kawashima, Junji, Matsumura, Takeshi, Ohba, Takashi, Yamaguchi, Munekage, Katabuchi, Hidetaka, Araki, Eiichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5789627/
https://www.ncbi.nlm.nih.gov/pubmed/29378555
http://dx.doi.org/10.1186/s12902-018-0234-6
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author Kondo, Tatsuya
Nakamura, Miwa
Kitano, Sayaka
Kawashima, Junji
Matsumura, Takeshi
Ohba, Takashi
Yamaguchi, Munekage
Katabuchi, Hidetaka
Araki, Eiichi
author_facet Kondo, Tatsuya
Nakamura, Miwa
Kitano, Sayaka
Kawashima, Junji
Matsumura, Takeshi
Ohba, Takashi
Yamaguchi, Munekage
Katabuchi, Hidetaka
Araki, Eiichi
author_sort Kondo, Tatsuya
collection PubMed
description BACKGROUND: Gestational diabetes insipidus (GDI) is a rare endocrine complication during pregnancy that is associated with vasopressinase overproduction from the placenta. Although increased vasopressinase is associated with placental volume, the regulation of placental growth in the later stage of pregnancy is not well known. CASE PRESENTATION: A 16-year-old pregnant woman was urgently transferred to our hospital because of threatened premature labor when the Kumamoto earthquakes hit the area where she lived. During her hospitalization, she complained of gradually increasing symptoms of polyuria and polydipsia. The serum level of arginine vasopressin (AVP) was 1.7 pg/mL, which is inconsistent with central DI. The challenge of diagnostic treatment using oral 1-deamino-8-D-AVP (DDAVP) successfully controlled her urine and allowed for normal delivery. DDAVP tablets were not necessary to control her polyuria thereafter. Based on these observations, clinical diagnosis of GDI was confirmed. Pathophysiological analyses revealed that vasopressinase expression was more abundant in the GDI patient’s syncytiotrophoblast in placenta compared with that in a control subject. Serum vasopressinase was also observed during gestation and disappeared soon after delivery. Vasopressinase is reportedly identical to oxytocinase or insulin regulated aminopeptidase (IRAP), which is an abundant cargo protein associated with the glucose transporter 4 (GLUT4) storage vesicle. Interestingly, the expression and subcellular localization of GLUT4 appeared to occur in a vasopressinase (IRAP)-dependent manner. CONCLUSION: Because placental volume may be associated with vasopressinase overproduction in GDI, vasopressinase (IRAP)/GLUT4 association appears to contribute to the growth of placenta in this case.
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spelling pubmed-57896272018-02-08 The clinical course and pathophysiological investigation of adolescent gestational diabetes insipidus: a case report Kondo, Tatsuya Nakamura, Miwa Kitano, Sayaka Kawashima, Junji Matsumura, Takeshi Ohba, Takashi Yamaguchi, Munekage Katabuchi, Hidetaka Araki, Eiichi BMC Endocr Disord Case Report BACKGROUND: Gestational diabetes insipidus (GDI) is a rare endocrine complication during pregnancy that is associated with vasopressinase overproduction from the placenta. Although increased vasopressinase is associated with placental volume, the regulation of placental growth in the later stage of pregnancy is not well known. CASE PRESENTATION: A 16-year-old pregnant woman was urgently transferred to our hospital because of threatened premature labor when the Kumamoto earthquakes hit the area where she lived. During her hospitalization, she complained of gradually increasing symptoms of polyuria and polydipsia. The serum level of arginine vasopressin (AVP) was 1.7 pg/mL, which is inconsistent with central DI. The challenge of diagnostic treatment using oral 1-deamino-8-D-AVP (DDAVP) successfully controlled her urine and allowed for normal delivery. DDAVP tablets were not necessary to control her polyuria thereafter. Based on these observations, clinical diagnosis of GDI was confirmed. Pathophysiological analyses revealed that vasopressinase expression was more abundant in the GDI patient’s syncytiotrophoblast in placenta compared with that in a control subject. Serum vasopressinase was also observed during gestation and disappeared soon after delivery. Vasopressinase is reportedly identical to oxytocinase or insulin regulated aminopeptidase (IRAP), which is an abundant cargo protein associated with the glucose transporter 4 (GLUT4) storage vesicle. Interestingly, the expression and subcellular localization of GLUT4 appeared to occur in a vasopressinase (IRAP)-dependent manner. CONCLUSION: Because placental volume may be associated with vasopressinase overproduction in GDI, vasopressinase (IRAP)/GLUT4 association appears to contribute to the growth of placenta in this case. BioMed Central 2018-01-30 /pmc/articles/PMC5789627/ /pubmed/29378555 http://dx.doi.org/10.1186/s12902-018-0234-6 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Kondo, Tatsuya
Nakamura, Miwa
Kitano, Sayaka
Kawashima, Junji
Matsumura, Takeshi
Ohba, Takashi
Yamaguchi, Munekage
Katabuchi, Hidetaka
Araki, Eiichi
The clinical course and pathophysiological investigation of adolescent gestational diabetes insipidus: a case report
title The clinical course and pathophysiological investigation of adolescent gestational diabetes insipidus: a case report
title_full The clinical course and pathophysiological investigation of adolescent gestational diabetes insipidus: a case report
title_fullStr The clinical course and pathophysiological investigation of adolescent gestational diabetes insipidus: a case report
title_full_unstemmed The clinical course and pathophysiological investigation of adolescent gestational diabetes insipidus: a case report
title_short The clinical course and pathophysiological investigation of adolescent gestational diabetes insipidus: a case report
title_sort clinical course and pathophysiological investigation of adolescent gestational diabetes insipidus: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5789627/
https://www.ncbi.nlm.nih.gov/pubmed/29378555
http://dx.doi.org/10.1186/s12902-018-0234-6
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