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Diabetes insipidus in a pediatric patient with systemic lupus erythematosus. A case report
1Department of Pediatrics, Osmangazi University Faculty of Medicine, Eskişehir.
Insights
Systemic lupus erythematosus (SLE) can affect the central nervous system (CNS), leading to diverse neurological symptoms. This case highlights a rare instance of CNS lupus presenting with diabetes insipidus (DI) in a young patient, successfully treated with immunosuppression and desmopressin.
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.
Abstract:
In systemic lupus erythematosus (SLE), the central nervous system (CNS) produces numerous and varying clinical disorders. A 14-year-old girl with the features of cerebral involvement in SLE is presented. The development of diabetes insipidus (DI), which responded to desmopressin, was an interesting finding in this case. Therapy consisting of high-dose methylprednisolone combined with cyclophosphamide was effective in improving the symptoms as well as the DI.