ASSOCIATION OF ARGININE VASOPRESSIN-SECRETING CELL, STEROID-SECRETINGCELL, ADRENAL AND ISLET-CELL ANTIBODIES IN A PATIENT PRESENTING WITH CENTRAL DIABETES-INSIPIDUS, EMPTY SELLA, SUBCLINICAL ADRENOCORTICAL FAILURE AND IMPAIRED GLUCOSE-TOLERANCE

A 36-year-old woman with central diabetes insipidus (DI), diagnosed wh en she was 7, was referred to our Endocrine Unit in January 1993 for f urther hormonal investigations. Clinical and laboratory findings confi rmed the diagnosis of central DI. Cranial computed tomography and magn etic resonance imaging showed only an empty sella. Moreover, we noted impaired glucose tolerance and unusual findings of subclinical adrenoc ortical failure, i.e. high plasma renin activity with normal aldostero ne levels, high ACTH despite normal basal and ACTH-stimulated cortisol levels. Immunological study of the patient's serum showed the presenc e of arginine vasopressin (AVP)-secreting cell antibodies (Abs), stero id-producing cell Abs, adrenal and islet cell Abs. The following aspec ts of our case are stressed and discussed: (1) the presence of AVP-sec reting cell Abs 29 years after the diagnosis of DI; (2) the associatio n between DI, empty sella and subclinical autoimmune adrenocortical fa ilure with unusual hormonal findings, and (3) impaired glucose toleran ce with islet cell antibody positivity.