RT Journal Article
SR Electronic
T1 Multifactorial diabetes insipidus during pregnancy: a challenging diagnosis
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e238410
DO 10.1136/bcr-2020-238410
VO 14
IS 3
A1 Alexandra Novais Araújo
A1 Maria Cunha
A1 Tiago Marques
A1 Maria João Guerreiro Martins Bugalho
YR 2021
UL http://casereports.bmj.com/content/14/3/e238410.abstract
AB Diabetes insipidus (DI) is characterised by thirst and polydipsia with hypotonic polyuria. Several forms exist, namely, central or pituitary, nephrogenic and gestational and must be differentiated for adequate treatment. We describe the case of a 41-year-old woman chronically infected with HIV who had been recently medicated with a tenofovir-based antiretroviral treatment and who, at 22 weeks of pregnancy, presented with transient gestational DI. Obstetric ultrasound revealed oligohydramnios and foetal growth restriction that did not improve despite serum sodium correction. The severity of the case suggested the presence of an underlying disorder and elevated copeptin levels indicated that an underlying subclinical form of nephrogenic DI, possibly induced by HIV-related nephropathy or tenofovir use, was present and rendered clinically overt during pregnancy.