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

Midori Sasaki Yatabe, Kimio Watanabe, Yoshimitsu Hayashi, Junichi Yatabe, Satoshi Morimoto, Atsuhiro Ichihara, Masaaki Nakayama, Tsuyoshi Watanabe

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)47-53
Number of pages7
JournalInternal Medicine
Volume56
Issue number1
DOIs
Publication statusPublished - 2017

Keywords

  • Diabetes insipidus
  • IgG4-related disease
  • Pituitary
  • Polyuria
  • Prednisolone
  • Retroperitoneal fibrosis

ASJC Scopus subject areas

  • Internal Medicine

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