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Desmopressin responding female nephrogenic diabetes insipidus: a case report

  • Juyeon, Lee (Department of Pediatrics, Ajou University School of Medicine) ;
  • Hae Il, Cheong (Department of Pediatrics, Hallym University Sacred Heart Hospital) ;
  • Jung Won, Lee (Department of Pediatrics, Ewha Womans University College of Medicine) ;
  • Ki Soo, Pai (Department of Pediatrics, Ajou University School of Medicine)
  • Received : 2022.10.07
  • Accepted : 2022.11.08
  • Published : 2022.12.31

Abstract

Nephrogenic diabetes insipidus, decreased ability to concentrate urine, with production of large amounts of urine, is caused by the refractory response of renal tubules to the action of antidiuretic hormone. This rare disorder, known as X-linked nephrogenic diabetes insipidus, is caused by a mutation in the AVPR2 gene. Because it is hereditary, most patients are male. This report highlights a case of nephrogenic diabetes insipidus in a 3-year 5-month-old female; upon presentation to the hospital, her symptoms included frequent urinationand consumptionof a significant amount ofwater,which had begun2 years ago. The results of blood tests showed increased levels of serum antidiuretic hormone, and sellar magnetic resonance imaging showed no abnormality. The results of the water restriction test and the desmopressin administration test confirmed the diagnosis of nephrogenic diabetes insipidus showing a partial response to desmopressin. The results of genetic testing indicated the presence of an AVPR2 mutation, a heterozygous missense mutation (p.Val88Met), suggesting inheritance of X-linked nephrogenic diabetes insipidus. This report describes a significant case of symptomaticX-linked nephrogenic diabetes insipidus in a female patient who showed a partial response to desmopressin.

Keywords

References

  1. Kim MJ, Cho JY, Park JS, Park ES, Seo JH, Lim JY, et al. A case of nephrogenic diabetes insipidus with a rare x-linked recessive mutation in an infant with developmental and growth retardation tracked by the Korean National Health Screening Program. Child Kidney Dis 2020;24:131-7.
  2. Arthus MF, Lonergan M, Crumley MJ, Naumova AK, Morin D, De Marco LA, et al. Report of 33 novel AVPR2 mutations and analysis of 117 families with X-linked nephrogenic diabetes insipidus. J Am Soc Nephrol 2000;11:1044-54.
  3. Spanakis E, Milord E, Gragnoli C. AVPR2 variants and mutations in nephrogenic diabetes insipidus: review and missense mutation significance.JCellPhysiol 2008;217:605-17.
  4. Ding C, Beetz R, Rittner G, Bartsch O. A female with X-linked nephrogenic diabetes insipidus in a family with inherited central diabetes insipidus: case report and review of the literature. Am J Med Genet A 2020;182:1032-40. https://doi.org/10.1002/ajmg.a.61516
  5. Rege T, Polsani S, Jim B. A rare case of congenital diabetes insipidus. Front Med (Lausanne) 2015;2:43.
  6. Bockenhauer D, Carpentier E, Rochdi D, van't Hoff W, Breton B, Bernier V, et al. Vasopressin type 2 receptor V88M mutation: molecular basis of partial and complete nephrogenic diabetes insipidus. Nephron Physiol 2010;114:1-10.
  7. Ishida A, Mizuno H, Aoyama K, Sasaki S, Negishi Y, Arakawa T, et al. Partial nephrogenic diabetes insipidus with a novel arginine vasopressin receptor 2 gene variant. Clin Pediatr Endocrinol 2022;31:44-9. https://doi.org/10.1297/cpe.2021-0029
  8. Kim WK, Lee JS, Ha TS. A familial case of nephrogenic diabetes insipidus associated with a mutation of the AVPR2 gene. J Korean Soc Pediatr Nephrol 2011;15:172-8. https://doi.org/10.3339/jkspn.2011.15.2.172
  9. Garcia Castano A, Perez de Nanclares G, Madariaga L, Aguirre M, Chocron S, Madrid A, et al. Novel mutations associated with nephrogenic diabetes insipidus: a clinical-genetic study. Eur J Pediatr 2015;174:1373-85.