Overlap of Post-obstructive Diuresis and Unmasked Diabetes Insipidus in a Case of IgG4-related Retroperitoneal Fibrosis and Tuberoinfundibular Hypophysitis: A Case Report and Review of the Literature
| Autor: | Satoshi Morimoto, Midori Yatabe, Yoshimitsu Hayashi, Kimio Watanabe, Atsuhiro Ichihara, Tsuyoshi Watanabe, Junichi Yatabe, Masaaki Nakayama |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty retroperitoneal fibrosis endocrine system diseases Hypophysitis Urology Diuresis Case Report 030209 endocrinology & metabolism Disease urologic and male genital diseases Retroperitoneal fibrosis pituitary 03 medical and health sciences 0302 clinical medicine Polyuria Anterior pituitary Internal medicine parasitic diseases Internal Medicine Humans Medicine Renal Insufficiency IgG4-related disease Glucocorticoids 030203 arthritis & rheumatology business.industry fungi prednisolone General Medicine Middle Aged medicine.disease Treatment Outcome medicine.anatomical_structure Endocrinology diabetes insipidus Immunoglobulin G Diabetes insipidus medicine.symptom business Glucocorticoid medicine.drug |
| Zdroj: | Internal Medicine |
| ISSN: | 1349-7235 0918-2918 |
| DOI: | 10.2169/internalmedicine.56.6648 |
| Popis: | The clinical picture of IgG4-related disease (IgG4-RD) is diverse because various organs can be affected. We describe the case of a 56-year-old man with acute renal failure and tuberoinfundibular hypophysitis due to IgG4-RD. Steroid therapy lowered the serum IgG4 level and ameliorated renal dysfunction, bilateral hydronephrosis and retroperitoneal fibrosis. However, polyuria from post-obstructive diuresis and unmasked central diabetes insipidus ensued. The patient's polyuria continued despite the administration of a therapeutic dose of glucocorticoid; the patient's pituitary swelling and anterior pituitary dysfunction were partially ameliorated. The pituitary swelling recurred seven months later. In patients with IgG4-RD, the manifestation of polyuria after steroid therapy should prompt suspicion of post-obstructive diuresis and the unmasking of central diabetes insipidus. |
| Databáze: | OpenAIRE |
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