Insipid diabetes as initial presentation of Wegener´s granulomatosis

Authors

  • Lorena Narváez Ponce Sección Reumatología, Servicio de Clínica Médica. Hospital Italiano de Buenos Aires y Fundación Dr. Pedro M. Catoggio para el Progreso de la Reumatología. Instituto Universitario Escuela de Medicina, Hospital Italiano de Buenos Aires.
  • Judith Carrió Sección Reumatología, Servicio de Clínica Médica. Hospital Italiano de Buenos Aires y Fundación Dr. Pedro M. Catoggio para el Progreso de la Reumatología. Instituto Universitario Escuela de Medicina, Hospital Italiano de Buenos Aires.
  • Enrique R. Soriano Sección Reumatología, Servicio de Clínica Médica. Hospital Italiano de Buenos Aires y Fundación Dr. Pedro M. Catoggio para el Progreso de la Reumatología. Instituto Universitario Escuela de Medicina, Hospital Italiano de Buenos Aires.
  • Carlos D. Santos Sección Reumatología, Servicio de Clínica Médica. Hospital Italiano de Buenos Aires y Fundación Dr. Pedro M. Catoggio para el Progreso de la Reumatología. Instituto Universitario Escuela de Medicina, Hospital Italiano de Buenos Aires.
  • Patricia M. Imamura Sección Reumatología, Servicio de Clínica Médica. Hospital Italiano de Buenos Aires y Fundación Dr. Pedro M. Catoggio para el Progreso de la Reumatología. Instituto Universitario Escuela de Medicina, Hospital Italiano de Buenos Aires.
  • Luis J. Catoggio Sección Reumatología, Servicio de Clínica Médica. Hospital Italiano de Buenos Aires y Fundación Dr. Pedro M. Catoggio para el Progreso de la Reumatología. Instituto Universitario Escuela de Medicina, Hospital Italiano de Buenos Aires.

DOI:

https://doi.org/10.31053/1853.0605.v66.n1.23538

Keywords:

Wegener´s granulomatosis, insipid diabetes, neurologic involvement

Abstract

Wegener´s granulomatosis is a granulomatous necrotizing vasculitis which predominantly affects the respiratory tract, kidney, and less frequently other organs such as the nervous system. 
The latter may occur in up to 54% of cases and when it does it is more frequently of the peripheral nerves. We present a 19 year old woman who commenced her disease with involvement of respiratory sinuses, lungs and kidney and who developed central insipid diabetes (CID) at onset. 
The CID persisted in spite of adequate response of the other organs and systems with immunosuppresor treatment. The development of CID in the context of vasculitis should suggest this as a possible mechanism.

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References

Wolfgang L.Gross. Wegener’s granulomatosis. Oxford Textbook of Rheumatology. Second edition. Vol:2, 1998; 1331-1351.

Barton F, Haynes MD, Fauci MD. Diabetes insipidus associated with Wegener`s granulomatosis successfully treated with ciclophosphamide. N Engl J Med 1978; 299:764-770.

Hoffman GS, Kerr GS, Leavitt RI, et al. Wegener´s granulomatoris : an analysis of 158 patients. Ann Intern Med 1992; 116: 448-58 [Abstract]

Jaroen Miesen WMA, Janssens NW, Bommel EFH. Diabetes insipidus as the presenting symptom of Wegener`granulomatosis. Nephr Dial Transplant 1999.14:426-429.[Full Text]

Garovic VD, Clarke BL, Chilson TS, Specks U.

Diabetes insipidus and anterior pituitary insufficiency as presenting features of Wegener`s granulomatosis. Am J of Kidney Dis 2001. 37;1:1-3.

Roberts GA, Eren E, Sinclair H, Pelling M, Burns A, Bradford R, Maurice-Williams R, Black CM, Finer N, Bouloux P-MG: Two cases of Wegener`s granulomatosis involving the pituitary. Clin Endocrinol 42:323-328. Abstract

Lohr KM, Ryan LM, Toohill RJ, Anderson T. Anterior pituitary involvement in Wegener`s granulomatosis. J Rheumatol1988; 15:855-857. Abstract

Fauci As, Haynes BF, Katz P, et al. Wegener´s granulomatosis: prospective clinical and therapeutic experience for 85 patients for 21 years. Ann Intern Med 1983; 98:76-80. Abstract

Nishino H, Rubino FA, De Remee RA, Swanson JW, Parisi JE. Neurologic involvement in Wegener´s granulomatosis: an analysis of 324 consecutive patients at the Mayo clinic. Ann Neurol 1993;33:4-9. Abstract

Yamada Y, Murate T, Shimokata K. A case of clinically suggested Wegener´s granulomatosis complicated by diabetes insipisdus. Nippon Hyobu Shikkan Gakkai Zasshi 1987: 25:668-674.

Colombo N, Berry I, Kucharczyk J, Kucharczyk W,

Groot J, Larson T, Norman D, Mewton T. Posterior pituitary gland: appearance on MR inages in normal and pathologic states. Radiology 1987;165:481-485.[Abstract]

Kerr GS, Fleischer TA, Hallahan CW, et al. Limited prognostic value of changes in antineutrophil cytoplasmic antibody titer in patients with Wegener´s granulomatosis. Arthritis Rheum 1993;36:365-368. [Abstract]

Hoffman GSm Specks U. Antineutrophol cytoplasmic antibodies (ANCA). Arthritis Rheum 1998, 41:1521-1525

Published

2009-02-25

How to Cite

1.
Ponce LN, Carrió J, Soriano ER, Santos CD, Imamura PM, Catoggio LJ. Insipid diabetes as initial presentation of Wegener´s granulomatosis. Rev Fac Cien Med Univ Nac Cordoba [Internet]. 2009 Feb. 25 [cited 2024 Jul. 21];66(1):31-5. Available from: https://revistas.unc.edu.ar/index.php/med/article/view/23538

Issue

Section

Case Report