Electrolytes & Blood Pressure  2017;15(1):23-25

doi:10.5049/EBP.2017.15.1.23

Central Diabetes Insipidus Linked to Rathke's Cleft Cyst, Polyuria in a 17-year-old Girl.

Ha Yeon KIM 1 ; Seung Jin LEE ; Eun Hui BAE ; Seong Kwon MA ; Soo Wan KIM

Affiliations

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Keywords

Central diabetes insipidus; Rathke's cleft cyst; Polyuria

Country

Republic of Korea

Language

English

Abstract

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.