Diabetes insipidus in a pediatric patient with systemic lupus erythematosus. A case report

Area of Science:

• Neurology
• Endocrinology
• Rheumatology

Background:

• Systemic lupus erythematosus (SLE) is a complex autoimmune disease with potential for central nervous system (CNS) involvement.
• CNS manifestations in SLE are diverse and can present with varied clinical neurological disorders.
• Cerebral involvement in SLE can lead to significant morbidity, necessitating comprehensive diagnostic and therapeutic approaches.

Observation:

• A 14-year-old female patient presented with clinical features indicative of cerebral involvement secondary to SLE.
• An unusual complication observed was the development of diabetes insipidus (DI), a condition affecting water balance.
• The diabetes insipidus demonstrated a positive response to desmopressin, a synthetic analog of vasopressin.

Findings:

• The presented case illustrates a rare association between SLE-related CNS dysfunction and the development of diabetes insipidus.
• Effective management involved a combination therapy including high-dose methylprednisolone and cyclophosphamide.
• This therapeutic regimen successfully ameliorated both the general SLE symptoms and the specific endocrine dysfunction (DI).

Implications:

• This case underscores the importance of considering endocrine complications, such as DI, in pediatric patients with CNS lupus.
• The findings suggest that aggressive immunosuppressive therapy can be beneficial for managing both neurological and endocrine manifestations of SLE.
• Further research into the mechanisms linking CNS lupus and DI may reveal novel therapeutic targets.