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...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
|
Materias: | |
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 |
_version_ | 1783296319194923008 |
---|---|
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. |
format | Online Article Text |
id | pubmed-5789627 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT kondotatsuya theclinicalcourseandpathophysiologicalinvestigationofadolescentgestationaldiabetesinsipidusacasereport AT nakamuramiwa theclinicalcourseandpathophysiologicalinvestigationofadolescentgestationaldiabetesinsipidusacasereport AT kitanosayaka theclinicalcourseandpathophysiologicalinvestigationofadolescentgestationaldiabetesinsipidusacasereport AT kawashimajunji theclinicalcourseandpathophysiologicalinvestigationofadolescentgestationaldiabetesinsipidusacasereport AT matsumuratakeshi theclinicalcourseandpathophysiologicalinvestigationofadolescentgestationaldiabetesinsipidusacasereport AT ohbatakashi theclinicalcourseandpathophysiologicalinvestigationofadolescentgestationaldiabetesinsipidusacasereport AT yamaguchimunekage theclinicalcourseandpathophysiologicalinvestigationofadolescentgestationaldiabetesinsipidusacasereport AT katabuchihidetaka theclinicalcourseandpathophysiologicalinvestigationofadolescentgestationaldiabetesinsipidusacasereport AT arakieiichi theclinicalcourseandpathophysiologicalinvestigationofadolescentgestationaldiabetesinsipidusacasereport AT kondotatsuya clinicalcourseandpathophysiologicalinvestigationofadolescentgestationaldiabetesinsipidusacasereport AT nakamuramiwa clinicalcourseandpathophysiologicalinvestigationofadolescentgestationaldiabetesinsipidusacasereport AT kitanosayaka clinicalcourseandpathophysiologicalinvestigationofadolescentgestationaldiabetesinsipidusacasereport AT kawashimajunji clinicalcourseandpathophysiologicalinvestigationofadolescentgestationaldiabetesinsipidusacasereport AT matsumuratakeshi clinicalcourseandpathophysiologicalinvestigationofadolescentgestationaldiabetesinsipidusacasereport AT ohbatakashi clinicalcourseandpathophysiologicalinvestigationofadolescentgestationaldiabetesinsipidusacasereport AT yamaguchimunekage clinicalcourseandpathophysiologicalinvestigationofadolescentgestationaldiabetesinsipidusacasereport AT katabuchihidetaka clinicalcourseandpathophysiologicalinvestigationofadolescentgestationaldiabetesinsipidusacasereport AT arakieiichi clinicalcourseandpathophysiologicalinvestigationofadolescentgestationaldiabetesinsipidusacasereport |