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CASE PRESENTATIONA 39-year-old Caucasian G4P2 woman at 27 weeks gestation was admitted to the hospital with newly diagnosed dilated cardiomyopathy and non-sustained ventricular tachycardia. Her urine output was 2.5-7 l/24 h. Serum magnesium levels were low despite repletion with up to 160 mEq of oral and i.v. magnesium daily. She had completed two prior pregnancies uneventfully, but complained of thirst, polyuria, and nocturia predating the current pregnancy by approximately 2 years. There was no history of lithium or diuretic use, head trauma, or neurological deficits. Past medical and family history was otherwise unremarkable. Physical examination revealed a well-appearing pregnant woman. Blood pressure was 80/60, jugular venous pressure was flat, and there was minimal peripheral edema. Laboratory values are shown in Table 1. Responses to 1-deamino-8-arginine vasopressin (dDAVP) and a water-deprivation test are shown in Figures 1 and 2.Kidney International (2006) 69, 938-941. doi:10.1038/sj.ki.5000256; published online 8 February 2006