Severe hyponatremia (serum sodium concentration <120 mEq/L) is a well-known etiology of acute symptomatic seizure. Severe hyponatremia may occur as a rare but clinically important adverse reaction of psychotrophic drugs. Among them, patients with psychogenic polydipsia have especially higher risk of severe hyponatremia. We present a schizophrenic patient with polydipsia who developed severe hyponatremia and symptomatic seizures while receiving olanzapine treatment.
Humans ; Hyponatremia ; Polydipsia ; Polydipsia, Psychogenic ; Seizures ; Sodium

Hyponatremia frequently occurs in patients with chronic schizophrenia and has various causes such as compulsive drinking, neuroleptics, and physical illness. If not corrected immediately, it leads to severe problems such as seizures, change in mental status, and even death. We detected five cases of hyponatremia with neurological symptoms in patients with chronic schizophrenia. One case had a long history of primary polydipsia, whereas the other four cases had no history of polydipsia. We speculated that the cause in these latter four cases was neuroleptics or physical illness. All five cases improved with conservative treatment. Possible implications and the need for future study are discussed.
Antipsychotic Agents ; Drinking ; Humans ; Hyponatremia* ; Polydipsia ; Polydipsia, Psychogenic ; Schizophrenia* ; Seizures

We report three cases of Diabetes insipidus which charactrized by the polyuria and polydipsia. All of the three cases well controlled with oral addministration of chlorpropamide. Two cases were idiopathic and the other was suspected pituitary tumor. A briet review of literature was made.
Chlorpropamide ; Diabetes Insipidus* ; Pituitary Neoplasms ; Polydipsia ; Polyuria

We report a case of immature teratoma arising at the suprasellar region in a 18 year-old-male who presented with bitemporal hemianopsia, nausea and polydipsia. The teratoma is a rare neoplasm consisting of 0.5% to 1.2% of all intracranial tumors. The clinical presentation, radiologic finding, pathology and treatment are briefly described with a review of other cases from the literature in view of clinical features and management.
Chemoradiotherapy ; Hemianopsia ; Nausea ; Pathology ; Polydipsia ; Teratoma*

Polydipsia occurs frequently in chronic schizophrenic patients, some of whom develop hyponatremia. Although the underlying pathophysiology of polydipsia among psychiatric patients, recent reports indicate that clozapine treatment improves polydipsia-hyponatremia in schizophrenia. Two schizophrenic patients with polydipsia, followed for more than two years, showed improvement on clozapine. Case 1 was a patient without history of hyponatremia who improved from polydipsia and psychosis. Case 2 was an inpatient with polydipsia and hyponatremia who showed improvement of polydipsia and did nor recur hyponatremia. The limited information provided by these case reports suggest the need for controlled studies of the clozapine effect on schizophrenic patients with polydipsia.
Clozapine* ; Humans ; Hyponatremia ; Inpatients ; Polydipsia* ; Psychotic Disorders ; Schizophrenia*

Hypotonic hyponatremia by primary polydipsia can cause severe neurologic complications due to cerebral edema. A 10-year-and-4-month-old boy with a psychiatric history of intellectual disability and behavioral disorders who presented with chief complaints of seizure and mental change showed severe hypotonic hyponatremia with low urine osmolality (serum sodium, 101 mmol/L; serum osmolality, 215 mOsm/kg; urine osmolality, 108 mOsm/kg). The patient had been polydipsic for a few months prior, and this had been worse in the previous few days. A diagnosis of hypotonic hyponatremia caused by primary polydipsia was made. The patient was in a coma, and developed respiratory arrest and became brain death shortly after admission, despite the treatment. The initial brain magnetic resonance imaging showed severe brain swelling with tonsillar and uncal herniation, and the patient was declared as brain death. It has been reported that antidiuretic hormone suppression is inadequate in patients with chronic polydipsia, and that this inadequate suppression of antidiuretic hormone is aggravated in patients with acute psychosis. Therefore, hyponatremia by primary polydipsia, although it is rare, can cause serious and life-threatening neurologic complications.
Brain Death* ; Brain Edema ; Brain* ; Child* ; Coma ; Diagnosis ; Humans ; Hyponatremia* ; Intellectual Disability ; Magnetic Resonance Imaging ; Male* ; Osmolar Concentration ; Polydipsia ; Polydipsia, Psychogenic* ; Psychotic Disorders ; Seizures ; Sodium ; Water Intoxication

Primary polydipsia (PP) is marked by an increase in thirst, and most often presents in patients with psychiatric illnesses. Although uncommon in children, we experienced cases of PP in a 15-month-old boy and a 5-year-old girl. Both were admitted to the hospital with symptoms of polydipsia and polyuria that appeared 1–3 months before admission. Brain magnetic resonance imaging in both patients was normal. A water restriction test was performed after hospitalization and showed normal results. The symptoms improved after the parents were instructed to implement water-intake restriction for 2 weeks. Our report provides useful information for the treatment of PP in children.
Brain ; Child ; Child, Preschool ; Diabetes Insipidus ; Female ; Hospitalization ; Humans ; Infant ; Magnetic Resonance Imaging ; Male ; Parents ; Polydipsia ; Polydipsia, Psychogenic ; Polyuria ; Thirst ; Water

Intrasellar or pituitary abscess was first reported about a century ago, after then once relatively common but now is rare. Since 1925, about 50 cases have been reported in the literatures, of which characters were variable, but clinical very similar to one of pituitary tumor. So they were often diagnosed preoperatively as pituitary tumor. Several pathogenic factors were postulated in relation to clinical aspects. We had recently experienced a case of pituitary abscess combined with chromophobe adenoma. A 28 years old clerkman was admitted to our hospital with complaints of impared ejaculation and visual disturbance. Clinical aspects and diagnostic studies gave us a strong impression of pituitary tumor. Upon surgery we found a cystic mass in pituitary region, of which aspiration showed whitish-gray, tenacious and liquid material. Many polymorphous leukocytes were noted by direct smear, but no microorganisms were detected in culture. He had postoperatively suffered from transient polyuria and polydipsia, which soon disappeared under the medication of Esidrex. He was discharged from this hospital with recommendation of radiation therapy. Clinical features and treatment were also discussed with review of ever reported cases.
Abscess* ; Adenoma, Chromophobe ; Adult ; Ejaculation ; Humans ; Hydrochlorothiazide ; Leukocytes ; Male ; Pituitary Neoplasms ; Polydipsia ; Polyuria

Autosomal dominant neurohypophyseal diabetes insipidus is a rare form of central diabetes insipidus that is caused by mutations in the vasopressin-neurophysin II (AVP-NPII) gene. It is characterized by persistent polydipsia and polyuria induced by deficient or absent secretion of arginine vasopressin (AVP). Here we report a case of familial neurohypophyseal diabetes insipidus in four generations of a Korean family, caused by heterozygous missense mutation in exon 2 of the AVP-NPII gene (c.286G>T). This is the first report of such a case in Korea.
Arginine Vasopressin ; Diabetes Insipidus, Neurogenic* ; Exons ; Family Characteristics* ; Humans ; Korea ; Mutation, Missense ; Polydipsia ; Polyuria

Nephrogenic diabetes insipidus(NDI) is characterized by an inability to concentrate urine despite normal or elevated plasma concentrations of the antidiuretic hormone; arginine vasopressin(AVP). Polyuria with hyposthenuria, and polydipsia are the cardinal clinical manifestations of the disease. Ninety percent of congenital nephrogenic diabetes insipidus patients are males with the X-linked recessive form of the disease; the mutation is in the AVP receptor 2 gene(AVPR2), which is located in chromosomal region Xq28. We report a case of NDI who suffered from unexplained fever and failure to thrive, which has been recognized since about 3 months after birth. His genomic DNA analysis identified a novel AVPR2 gene mutation as W200C.
Arginine ; Diabetes Insipidus, Nephrogenic* ; DNA* ; Failure to Thrive ; Fever ; Humans ; Male ; Parturition ; Plasma ; Polydipsia ; Polyuria