Hyperandrogenism and gestational diabetes insipidus: The report of one case

Hyperandrogenism combined with gestational diabetes insipidus is rare. We present a 35-year old nulliparous woman with polycystic ovarian syndrome, who developed coexistence of markedly elevated serum testosterone, more than 20 times normal, and diabetes insipidus during the third trimester of pregnancy. The pregnancy was terminated by cesarean delivery of a healthy 1482 g female infant during the 32nd week of pregnancy, The female infant showed no evidence of virilization. Magnetic resonance imaging of the mother's sella turcica after delivery showed decreased enhancement of the posterior lobe and an otherwise normal pituitary gland. A water deprivation test revealed partial central diabetes insipidus. The markedly elevated serum testosterone level and gestational diabetes insipidus resolved after delivery. Both the mother and daughter were discharged after an uneventful postpartum course. Hyperandrogenism may be due to an increased testosterone production rate, caused by human chorionic gonadotrophin stimulation of the polycystic ovaries. The gestational diabetes insipidus remains unexplained.