Systemic necrotizing vasculitis presenting as gangrene combined with diabetes insipi-dus:a case report
10.3969/j.issn.1671-167X.2015.06.025
- VernacularTitle:肢端坏疽合并尿崩症1例
- Author:
Qing HUANG
;
Yulan LIU
- Publication Type:Journal Article
- Keywords:
Gangrene;
Diabetes insipidus;
Vasculitis
- From:
Journal of Peking University(Health Sciences)
2015;47(6):1028-1030
- CountryChina
- Language:Chinese
-
Abstract:
SUMMARY The male patient reported here presented as gangrene and central diabetes insipidus ( CDI) , who had characteristics of vasculitis. The patient complained about polydipsia and polyuria half a year ago, and then developed tingling, pain and blackish discoloration of some fingers and toes 3 month ago. He also had Raynaud' s phenomenon. After admission, his laboratory examination showed the rise of erythrocyte sedimentation rate, C-reactive protein, immunoglobulin,β2-glycoproteinⅠand the activi-ty of rheumatoid factors, lupus anticoagulant test. his pituitary gland showed loss of posterior signal on magnetic resonance imaging. In addition, his vasopressin test was active. However, there was no suffi-cient evidence to diagnose any specific disease;as a consequence the patient was diagnosed as idiopathic systemic necrotizing vasculitis ( SNV) . For SNV, the patient was treated with glucocorticoid 40 mg/d and impact therapy of cyclophosphamide 0. 4 g every 2 weeks. He also received symptomatic treatment for gangrene and CDI. Cutaneous involvement leading to gangrene was widely reported in SNV, however pi-tuitary involvement in SNV leading to CDI was rare. The prognosis of this patient was poor.
