Studies on anti-rabphilin-3A antibodies in 15 consecutive patients presenting with central diabetes insipidus at a single referral center

Zenei Arihara; Kanako Sakurai; Satsuki Niitsuma; Ryota Sato; Shozo Yamada; Naoko Inoshita; Naoko Iwata; Haruki Fujisawa; Takashi Watanabe; Atsushi Suzuki; Kazuhiro Takahashi; Yoshihisa Sugimura

doi:10.1038/s41598-022-08552-y

Studies on anti-rabphilin-3A antibodies in 15 consecutive patients presenting with central diabetes insipidus at a single referral center

Sci Rep. 2022 Mar 15;12(1):4440. doi: 10.1038/s41598-022-08552-y.

Authors

Affiliations

¹ Department of Endocrinology and Metabolism, National Hospital Organization, Sendai Medical Center, Sendai, Miyagi, 983-8520, Japan. arihara-zen@umin.ac.jp.
² Department of Endocrinology and Metabolism, National Hospital Organization, Sendai Medical Center, Sendai, Miyagi, 983-8520, Japan.
³ Hypothalamic and Pituitary Center, Moriyama Neurological Center Hospital, Edogawa, Tokyo, 134-0081, Japan.
⁴ Department of Pathology, Tokyo Metropolitan Geriatric Hospital, Itabashi, Tokyo, 173-0015, Japan.
⁵ Department of Endocrinology and Diabetes, Daido Hospital, Nagoya, Aichi, 457-8511, Japan.
⁶ Department of Endocrinology, Diabetes and Metabolism, Fujita Health University, Toyoake, Aichi, 470-1192, Japan.
⁷ Department of Biochemistry, Fujita Health University, Toyoake, Aichi, 470-1192, Japan.
⁸ Department of Endocrinology and Applied Medical Science, Tohoku University Graduate School of Medicine, Sendai, Miyagi, 980-8585, Japan.

Abstract

Central diabetes insipidus (CDI) is a rare condition caused by various underlying diseases including inflammatory and autoimmune diseases, and neoplasms. Obtaining an accurate definitive diagnosis of the underlying cause of CDI is difficult. Recently, anti-rabphilin-3A antibodies were demonstrated to be a highly sensitive and specific marker of lymphocytic infundibuloneurohypophysitis (LINH). Here, we report a detailed case series, and evaluated the significance of anti-rabphilin-3A antibodies in differentiating the etiologies of CDI. A prospective analysis was conducted in 15 consecutive patients with CDI from 2013 to 2020 at a single referral center. Anti-rabphilin-3A antibodies were measured and the relationship between antibody positivity and the clinical/histopathological diagnoses was evaluated. Among 15 CDI patients, the positive anti-rabphilin-3A antibodies were found in 4 of 5 LINH cases, 3 of 4 lymphocytic panhypophysitis (LPH) cases, one of 2 sarcoidosis cases, and one intracranial germinoma case, respectively. Two Rathke cleft cyst cases and one craniopharyngioma case were negative. This is the first report of anti-rabphilin-3A antibodies positivity in CDI patients with biopsy-proven LPH. Measurement of anti-rabphilin-3A antibodies may be valuable for differentiating CDI etiologies.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Autoimmune Diseases* / complications
Autoimmune Hypophysitis*
Diabetes Insipidus, Neurogenic* / diagnosis
Diabetes Insipidus, Neurogenic* / etiology
Diabetes Mellitus*
Female
Humans
Male
Referral and Consultation
Sarcoidosis* / complications