Aged ; Diabetes Insipidus ; etiology ; Esthesioneuroblastoma, Olfactory ; complications ; Female ; Humans

A 13-year-old boy was diagnosed as having primary nephrogenic diabetes insipidus, and symptoms developed at 3 years of age. Subsequently he developed bilateral hydronephrosis and a neurogenic bladder. His pedigree could be explored back 5 generations and represented an inheritance as an X-linked recessive transmission factor. He was treated with indomethacin 2 mg/kg/day plus chlorothiazide 500 mg/day and this new treatment showed a markedly decreased urine output and increased urine osmolarity. (Nephrogenic diabetes insipidus, Hydronephrosis, Indomethacin)
Adolescent ; Bladder, Neurogenic/etiology ; Chlorothiazide/therapeutic use ; Diabetes Insipidus/complications ; Diabetes Insipidus/congenital* ; Diabetes Insipidus/drug therapy ; Diabetes Insipidus/genetics ; Drug Therapy, Combination ; Human ; Hydronephrosis/etiology* ; Indomethacin/therapeutic use* ; Male

OBJECTIVETo summarize our experience in the management of adipsic central diabetes insipidus(ADI) accompanied with intracranial calcification.

METHODThe clinical data of one ADI patient accompanied with intracranial calcification who was treated in our hospital since December 2011 were retrospectively summarized.

RESULTSThe 24-hour urine volume was 800 ml. She didn't feel thirsty even with increased plasma sodium concentration(153 mmol/L) and blood osmotic pressure(333 mmol/L) . Combined water deprivation and vasopressin test revealed the diagnosis of central diabetes insipidus. The high intensity signal(on T1-weighted magnetic resonance imaging) in the posterior lobe of pituitary gland was found. Computed tomography showed calcifications in the bilateral basal ganglia.Serum cytomegalovirus IgG was positive. She was treated with desmopressin and asked for regular water intake regardless of the adipsia. The plasma sodium concentration was still below 150 mmol/L during the 4-month follow-up.

CONCLUSIONSRoutine adipsia evaluation and combined water deprivation and vasopressin test are critical for the diagnosis and treatment of ADI. Past insidious intracranial cytomegalovirus infection may explain the cause of ADI and calcification.

Brain Diseases ; complications ; Calcinosis ; complications ; Child ; Cytomegalovirus ; Diabetes Insipidus, Neurogenic ; complications ; diagnosis ; etiology ; Drinking ; Female ; Humans ; Sodium ; blood

OBJECTIVETo study the prevention and treatment of postoperative diabetes insipidus after removal of pituitary tumor through transsphenoidal operation, to decrease the incidence of postoperative complications and improve the treatment of pituitary tumor.

METHODSThe clinical data of 86 cases of transsphenoidal resection of pituitary tumor in recent 8 years were retrospectively reviewed, including 35 endoscopic operation and 51 microscopic operation. The incidence, prevention and treatment of diabetes insipidus were statistically analysed.

RESULTSThere were 18 cases of postoperative diabetes insipidus in total of 86 operations, including 15 acute cases, 3 delayed cases. Twelve were temporary , which recovered within 1 week. After prompt treatment, 14 recovered within 1 week, 4 recovered within 2 weeks. No persistent diabetes insipidus was found.

CONCLUSIONSThe key points to prevent postoperative diabetes insipidus lay in the improvement of operative skills, careful protection during operation and avoidance of unnecessary injury. In case of diabetes insipidus occurred, rational use of antidiuretics and correction of electrolyte balance were effective in the treatment of postoperative diabetes insipidus.

Adult ; Diabetes Insipidus ; etiology ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Pituitary Neoplasms ; surgery ; Postoperative Complications ; etiology ; Retrospective Studies ; Sphenoid Sinus ; surgery

Central diabetes insipidus (DI), characterized by unexpected fatal hypernatremia, is a rare complication after successful cardiopulmonary resuscitation with therapeutic hypothermia, but may be potentially fatal if recognition is delayed. We describe here a patient who experienced cardiac arrest due to a pulmonary embolism, followed by successful resuscitation after induction of therapeutic hypothermia. The patient, however, suddenly developed unexpected hypernatremia with increased urine output and was diagnosed with central DI as a complication of cerebral edema, and eventually died. Our findings suggest that central DI should be considered as a possible complication following unexpected hypernatremia with increased urine output during therapeutic hypothermia and that desmopressin acetate should be used to treat central DI.
Adult ; Cardiopulmonary Resuscitation/*adverse effects ; Diabetes Insipidus, Neurogenic/diagnosis/etiology ; Fatal Outcome ; Female ; Heart Arrest/complications/therapy ; Humans ; Hypernatremia/*etiology ; Hypothermia, Induced/*adverse effects ; Pulmonary Embolism/complications

Metastatic brain tumors from gastric cancer are extremely rare. A 61-year-old Korean woman, initially presenting with polydipsia and polyuria, was found to have metastatic lesions in the brain by MRI. We performed several diagnostic procedures to determine the origin of the brain metastases. She was revealed to have a soft tissue mass of the right adrenal gland and fungating ulcers in the stomach. Histologic studies of both the adrenal gland mass and gastric tissues revealed malignant tumors composed of anaplastic cells. Based on the electron microscopy study, the malignant tumor of the right adrenal gland was a metastatic lesion from the anaplastic carcinoma of stomach. Therefore, the malignant tumors of the brain were assumed to have originated from the gastric cancer. This case report is presented to make clinicians aware of the possibility that diabetes insipidus (polydipsia) may present as an initial manifestation of brain metastases.
Adrenal Gland Neoplasms/diagnosis/*secondary ; Brain Neoplasms/diagnosis/*secondary ; Carcinoma/*diagnosis ; Diabetes Insipidus/*etiology ; Female ; Humans ; Middle Aged ; Stomach Neoplasms/*diagnosis

Rathke's Cleft Cyst (RCC), which is located at the intrasellar region, is considered to be the distended remnants of Rathke's pouch, an invagination of the stomodeum. Lined with columnar or cuboidal epithelium of ectodermal origin, RCC usually contains mucoid material and it is found in 13-22% of normal pituitary glands. The cyst rarely leads to the development of symptoms but, when it does, the most common presenting symptoms are headache, visual impairment, hypopituitarism and hypothalamic dysfunction. However, in some cases it presents symptoms of diabetes insipidus, decreased libido and impotence. Recently we experienced a case of RCC inflammation presenting with diabetes insipidus and treated with transsphenoidal surgery. To our knowledge, this is the first report of RCC presenting with symptoms of diabetes insipidus in Korea.
Aged ; Case Report ; Central Nervous System Cysts/complications/*diagnosis/surgery ; Diabetes Insipidus/diagnosis/*etiology ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Human ; Pituitary Neoplasms/complications/*diagnosis/surgery

We report a rare case of diabetes insipidus following fire burn injury. Meticulous fluid balance and the use of carbamazepine resulted in her survival.
Burns/*complications ; Carbamazepine/therapeutic use ; Diabetes Insipidus, Neurogenic/drug therapy/*etiology ; Female ; Fires ; Fluid Therapy/methods ; Humans ; Self-Injurious Behavior ; Young Adult

Nephrogenic diabetes insipidus (DI) secondary to chronic urinary tract obstruction is a rare disease. The exact cause is unknown but it is likely that increased collecting duct pressures cause damage to the tubular epithelium, resulting in insensitivity to the action of arginine-vasopressin (AVP). A 77-year-old man complaining of polyuria and polydipsia was treated with alpha glucosidase inhibitor under the impression of polyuria due to diabetes mellitus. But his symptoms did not improve. Water deprivation and AVP administration study revealed that the patient had nephrogenic DI. Urinary tract obstruction due to an enlarged prostate was suggested as a principal cause of nephrogenic DI. The patient underwent transurethral resection of the prostate and bilateral subcapsular orchiectomy. After surgery, the urine osmolarity was normalized and the patient became symptom-free. We report a case of nephrogenic DI due to obstructive uropathy which was cured by surgery eliminating obstruction.
Adenocarcinoma/ultrasonography ; Adenocarcinoma/radionuclide imaging ; Adenocarcinoma/pathology ; Adenocarcinoma/complications* ; Aged ; Case Report ; Constriction, Pathologic/etiology ; Diabetes Insipidus, Nephrogenic/etiology* ; Human ; Male ; Prostatic Neoplasms/ultrasonography ; Prostatic Neoplasms/radionuclide imaging ; Prostatic Neoplasms/pathology ; Prostatic Neoplasms/complications* ; Urologic Diseases/etiology*

Lymphocytic hypophysitis is a rare inflammatory disorder in the pituitary gland. The lesion is usually confined to the adenohypophysis. Although the involvement of the posterior pituitary gland or the stalk is rare, such patients with diabetes insipidus have been reported. Surgery has been used to make the definitive diagnosis. Recent studies suggest, however, that the pathologic diagnosis may not be necessary always. We reported a case of Lymphocytic hypophysitis managed by methylprednisolone pulse therapy. A 50-year-old premenopausal woman with Lymphocytic hypophysitis and diabetes insipidus was treated with methylprednisolone pulse therapy. Her adenopituitary lesion disappeared and the diabetes insipidus resolved. The optimal management for patients with lymphocytic hypophysitis may be the high index of the suspicion prior to the extensive surgical resection. In addition, methylprednisolone pulse therapy may improve the clinical and MRI findings.
Anti-Inflammatory Agents/*administration & dosage ; Diabetes Insipidus/*drug therapy/etiology ; Female ; Humans ; Lymphocytosis/complications/*drug therapy ; Methylprednisolone/*administration & dosage ; Middle Aged ; Pituitary Diseases/complications/*drug therapy ; Pulse Therapy, Drug