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Diabetes insipidus (DI) is a condition characterized by large amounts of dilute urine and increased thirst. [1] The amount of urine produced can be nearly 20 liters per day. [ 1 ] Reduction of fluid has little effect on the concentration of the urine. [ 1 ]
Neoplastic conditions - Central diabetes insipidus can result from primary or secondary brain malignancies that affect the hypothalamic-pituitary area; secondary tumors are typically caused by metastasis from lung or breast cancer, leukemia, or lymphoma. [14] Additionally, central diabetes insipidus is seen in myelodysplastic syndrome. [15]
Autoimmune hypophysitis can lead to deficiencies in one or more pituitary hormones, causing central diabetes insipidus if the posterior pituitary gland is affected as well as central adrenal insufficiency and central hypothyroidism if the anterior pituitary gland is affected. [1] The symptoms depend on what part of the pituitary is affected.
A fluid or water deprivation test is a medical test [1] which can be used to determine whether the patient has diabetes insipidus as opposed to other causes of polydipsia (a condition of excessive thirst that causes an excessive intake of water). The patient is required, for a prolonged period, to forgo intake of water completely, to determine ...
Diabetes insipidus (can also be nephrogenic) underproduction: vasopressin: Sheehan syndrome: underproduction: any pituitary hormone: Pickardt-Fahlbusch Syndrome: underproduction: any pituitary hormone, except prolactin, which is increased Hyperpituitarism (most commonly pituitary adenoma) overproduction: any pituitary hormone Hypopituitarism ...
Finally, 10–25% develop diabetes insipidus, the inability to retain fluid in the kidneys due to a lack of the pituitary antidiuretic hormone. This may be treated with the drug desmopressin , [ 1 ] which can be applied as a nose spray or taken by mouth.
If the urine then becomes concentrated and the blood osmolarity falls, there is a lack of ADH due to lack of pituitary function ("cranial diabetes insipidus"). In contrast, there is no change if the kidneys are unresponsive to ADH due to a different problem ("nephrogenic diabetes insipidus"). [1]
In salt intoxication, the urine sodium concentrations are very high and fractional excretion of sodium is greater than 1%. Initial test results may be suggestive of diabetes insipidus. The circulating AVP levels tend to be high, which indicate an appropriate response of the pituitary to hyperosmolality. Patients may have mild stable elevations ...