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Arginine vasopressin deficiency onset after COVID-19 vaccination with positive anti-rabphilin-3A antibodies: a case report and literature review.

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Title: Arginine vasopressin deficiency onset after COVID-19 vaccination with positive anti-rabphilin-3A antibodies: a case report and literature review.
Authors: Takizawa, Hiroki, Goto, Hiromasa, Uchida, Toyoyoshi, Aoyama, Shuhei, Fujisawa, Haruki, Iwata, Naoko, Suzuki, Atsushi, Sugimura, Yoshihisa, Watada, Hirotaka
Source: BMC Endocrine Disorders; 8/6/2024, Vol. 24 Issue 1, p1-7, 7p
Subject Terms: VASOPRESSIN, IMMUNIZATION, DIFFERENTIAL diagnosis, PITUITARY gland, COVID-19 vaccines, MAGNETIC resonance imaging, AGE factors in disease, MONOCLONAL antibodies, POLYURIA, INFLAMMATION, POLYDIPSIA
Abstract: Background: Arginine vasopressin deficiency (AVP-D) can occur due to various conditions, so clarifying its cause is important for deciding treatment strategy. Although several cases of AVP-D following coronavirus disease 2019(COVID-19) infection or COVID-19 vaccination have been reported, the diagnosis of the underlying disease has not been reported in most cases. Case presentation: A 75-year-old woman who presented with polydipsia and polyuria 9 weeks after contracting COVID-19 and 5 weeks after receiving the SARS-CoV-2 vaccination, leading to the final diagnosis of AVP-D 8 months after the first appearance of symptoms. Interestingly, pituitary magnetic resonance imaging (MRI) still revealed stalk enlargement frequently observed in patients with SARS-CoV-2 vaccination-induced AVP-D. Although this finding could not rule out any malignancies, we additionally measured anti-rabphilin-3A antibodies, a known marker for lymphocytic infundibulo-neurohypophysitis (LINH), and found that the results were positive, strongly suggesting LINH as the cause of this disease. Thus, we avoided pituitary biopsy. At the follow-up MRI conducted 12 months after the initial consultation, enlargement of the pituitary stalk was still observed. Conclusion: We experienced a case with LINH probably induced by SARS-CoV-2 vaccination. In SARS-CoV-2 vaccination-related LINH, unlike typical LINH, there is a possibility of persistent pituitary stalk enlargement on MRI images for an extended period, posing challenges in differential diagnosis from other conditions. Pituitary stalk enlargement and positive anti-rabphilin-3A antibodies may help in the diagnosis of AVP-D induced by SARS-CoV-2 vaccination. [ABSTRACT FROM AUTHOR]
Copyright of BMC Endocrine Disorders is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Label: Title
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  Data: Arginine vasopressin deficiency onset after COVID-19 vaccination with positive anti-rabphilin-3A antibodies: a case report and literature review.
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  Data: <searchLink fieldCode="AR" term="%22Takizawa%2C+Hiroki%22">Takizawa, Hiroki</searchLink><br /><searchLink fieldCode="AR" term="%22Goto%2C+Hiromasa%22">Goto, Hiromasa</searchLink><br /><searchLink fieldCode="AR" term="%22Uchida%2C+Toyoyoshi%22">Uchida, Toyoyoshi</searchLink><br /><searchLink fieldCode="AR" term="%22Aoyama%2C+Shuhei%22">Aoyama, Shuhei</searchLink><br /><searchLink fieldCode="AR" term="%22Fujisawa%2C+Haruki%22">Fujisawa, Haruki</searchLink><br /><searchLink fieldCode="AR" term="%22Iwata%2C+Naoko%22">Iwata, Naoko</searchLink><br /><searchLink fieldCode="AR" term="%22Suzuki%2C+Atsushi%22">Suzuki, Atsushi</searchLink><br /><searchLink fieldCode="AR" term="%22Sugimura%2C+Yoshihisa%22">Sugimura, Yoshihisa</searchLink><br /><searchLink fieldCode="AR" term="%22Watada%2C+Hirotaka%22">Watada, Hirotaka</searchLink>
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  Data: BMC Endocrine Disorders; 8/6/2024, Vol. 24 Issue 1, p1-7, 7p
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  Data: <searchLink fieldCode="DE" term="%22VASOPRESSIN%22">VASOPRESSIN</searchLink><br /><searchLink fieldCode="DE" term="%22IMMUNIZATION%22">IMMUNIZATION</searchLink><br /><searchLink fieldCode="DE" term="%22DIFFERENTIAL+diagnosis%22">DIFFERENTIAL diagnosis</searchLink><br /><searchLink fieldCode="DE" term="%22PITUITARY+gland%22">PITUITARY gland</searchLink><br /><searchLink fieldCode="DE" term="%22COVID-19+vaccines%22">COVID-19 vaccines</searchLink><br /><searchLink fieldCode="DE" term="%22MAGNETIC+resonance+imaging%22">MAGNETIC resonance imaging</searchLink><br /><searchLink fieldCode="DE" term="%22AGE+factors+in+disease%22">AGE factors in disease</searchLink><br /><searchLink fieldCode="DE" term="%22MONOCLONAL+antibodies%22">MONOCLONAL antibodies</searchLink><br /><searchLink fieldCode="DE" term="%22POLYURIA%22">POLYURIA</searchLink><br /><searchLink fieldCode="DE" term="%22INFLAMMATION%22">INFLAMMATION</searchLink><br /><searchLink fieldCode="DE" term="%22POLYDIPSIA%22">POLYDIPSIA</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Arginine vasopressin deficiency (AVP-D) can occur due to various conditions, so clarifying its cause is important for deciding treatment strategy. Although several cases of AVP-D following coronavirus disease 2019(COVID-19) infection or COVID-19 vaccination have been reported, the diagnosis of the underlying disease has not been reported in most cases. Case presentation: A 75-year-old woman who presented with polydipsia and polyuria 9 weeks after contracting COVID-19 and 5 weeks after receiving the SARS-CoV-2 vaccination, leading to the final diagnosis of AVP-D 8 months after the first appearance of symptoms. Interestingly, pituitary magnetic resonance imaging (MRI) still revealed stalk enlargement frequently observed in patients with SARS-CoV-2 vaccination-induced AVP-D. Although this finding could not rule out any malignancies, we additionally measured anti-rabphilin-3A antibodies, a known marker for lymphocytic infundibulo-neurohypophysitis (LINH), and found that the results were positive, strongly suggesting LINH as the cause of this disease. Thus, we avoided pituitary biopsy. At the follow-up MRI conducted 12 months after the initial consultation, enlargement of the pituitary stalk was still observed. Conclusion: We experienced a case with LINH probably induced by SARS-CoV-2 vaccination. In SARS-CoV-2 vaccination-related LINH, unlike typical LINH, there is a possibility of persistent pituitary stalk enlargement on MRI images for an extended period, posing challenges in differential diagnosis from other conditions. Pituitary stalk enlargement and positive anti-rabphilin-3A antibodies may help in the diagnosis of AVP-D induced by SARS-CoV-2 vaccination. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label:
  Group: Ab
  Data: <i>Copyright of BMC Endocrine Disorders is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1186/s12902-024-01664-8
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      – Code: eng
        Text: English
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        PageCount: 7
        StartPage: 1
    Subjects:
      – SubjectFull: VASOPRESSIN
        Type: general
      – SubjectFull: IMMUNIZATION
        Type: general
      – SubjectFull: DIFFERENTIAL diagnosis
        Type: general
      – SubjectFull: PITUITARY gland
        Type: general
      – SubjectFull: COVID-19 vaccines
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      – SubjectFull: MAGNETIC resonance imaging
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      – SubjectFull: AGE factors in disease
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      – SubjectFull: POLYURIA
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      – SubjectFull: INFLAMMATION
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      – SubjectFull: POLYDIPSIA
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              Text: 8/6/2024
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              Y: 2024
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