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KMID : 1128320170150010023
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Electrolytes & Blood Pressure
2017 Volume.15 No. 1 p.23 ~ p.25
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Central Diabetes Insipidus Linked to Rathke's Cleft Cyst, Polyuria in a 17-year-old Girl
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Kim Ha-Yeon
Lee Seung-Jin
Bae Eun-Hui
Ma Seong-Kwon
Kim Soo-Wan
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Abstract
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A 17-year-old girl presented with polyuria (7 L/day) and polydipsia for one year. Initial urine osmolality was 113mOsm/kg H2O. Following 6 h of fluid restriction, serum plasma osmolality reached 300mOsm/kg H2O, whereas urine osmolality was 108mOsm/kg H2O. 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.
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KEYWORD
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Central diabetes insipidus, Rathke's cleft cyst, Polyuria
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