Diagnosis and tactics of managing a patient with central diabetes insipidus on the example of a clinical case
https://doi.org/10.14341/probl13103
Abstract
Diagnosis and differential diagnosis of patients with diabetes insipidus is often a difficult task for the endocrinologist. This case report focuses on a patient with a long history of central idiopathic diabetes insipidus who had a substantial decrease in desmopressin requirements during the last year of follow-up. Conducting tests with osmotic stimulation (test with water deprivation, infusion test with hypertonic solution) made it possible to answer the question of the persistence of the disease, as well as to determine a further management plan, taking into account the physiological characteristics of our patient.
About the Authors
N. N. Katamadze
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Nino N. Katamadze.
Dmitry Ulyanova street 11 bld 2, 117036 Moscow.
SPIN-код: 6755-9320
Competing Interests:
None
E. A. Pigarova
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Ekaterina A. Pigarova - MD, PhD.
Moscow.
SPIN-код: 6912-6331
Competing Interests:
None
L. K. Dzeranova
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Larisa K. Dzeranova.
Moscow.
SPIN-код: 2958-5555
Competing Interests:
None
References
1. Dedov II, Mel’nichenko GA, Pigarova EA, et al. Federal clinical guidelines on diagnosis and treatment of diabetes insipidus in adults. Obesity and metabolism. 2018;15(2):56-71. (In Russ.). doi: https://doi.org/10.14341/omet9670
2. Kennedy RM, Earley LE. Profound Hyponatremia Resulting from a Thiazide-Induced Decrease in Urinary Diluting Capacity in a Patient with Primary Polydipsia. N Engl J Med. 1970;282(21):1185-1186. doi: https://doi.org/10.1056/NEJM197005212822107
3. Short JR, Isles A. Diabetes insipidus treated by DDAVP. Med J Aust. 1976;1(20):756-757. doi: https://doi.org/10.5694/j.1326-5377.1976.tb141028.x
4. Harris AS, Hedner P, Vilhardt H. Nasal administration of desmopressin by spray and drops. J Pharm Pharmacol. 2011;39(11):932-934. doi: https://doi.org/10.1111/j.2042-7158.1987.tb03131.x
5. Pigarova EA, Dzeranova LK, Rozhinskaya LY. Klinicheskiy sluchay primeneniya preparata Presayneks u patsientki s tsentral’nym nesakharnym diabetom. RMZh. 2011;19(27):1714-1716. (In Russ.).
6. Pigarova EA, Dzeranova LK. Diagnosis and treatment of central diabetes insipidus. Obesity and metabolism. 2014;11(4):48-55. (In Russ.). doi: https://doi.org/10.14341/omet2014448-55
7. Kronenberg GM, Melmed S, Kennet S. Endokrinologiya po Vil’yamsu. Neyroendokrinologiya. Moscow: Rid Elsiver; 2010. P. 401-418. (In Russ.).
8. De Bellis A, Colao A, Di Salle F, et al. A Longitudinal Study of Vasopressin Cell Antibodies, Posterior Pituitary Function, and Magnetic Resonance Imaging Evaluations in Subclinical Autoimmune Central Diabetes Insipidus. J Clin Endocrinol Metab. 1999;84(9):3047-3051. doi: https://doi.org/10.1210/jcem.84.9.5945
9. Pivonello R, De Bellis A, Faggiano A, et al. Central Diabetes Insipidus and Autoimmunity: Relationship between the Occurrence of Antibodies to Arginine Vasopressin-Secreting Cells and Clinical, Immunological, and Radiological Features in a Large Cohort of Patients with Central Diabetes Insipidus. J Clin Endocrinol Metab. 2003;88(4):1629-1636. doi: https://doi.org/10.1210/jc.2002-020791
10. Dzeranova LK, Mikaylova DS, Pigarova EA, et al. Options for individualizing therapy for postoperative central diabetes insipidus. Obesity and metabolism. 2017;14(3):54-57. (In Russ.). doi: https://doi.org/10.14341/omet2017354-57
11. Ohshima K, Okada S, Onai T, et al. Diabetes insipidus with spontaneous remission. J Endocrinol Invest. 1989;12(10):713-715. doi: https://doi.org/10.1007/BF03350038
12. Martini G, Filosomi G, Valenti R, et al. Central diabetes insipidus with spontaneous remission. A case report. Recenti Prog Med. 1998;89(9):450-453.
13. Juul KV, Erichsen L, Robertson GL. Temporal delays and individual variation in antidiuretic response to desmopressin. Am J Physiol Physiol. 2013;304(3):F268-F278. doi: https://doi.org/10.1152/ajprenal.00502.2012
14. Kwiatkowska A, Sobolewski D, Prahl A, et al. Arginine vasopressin and its analogues – The influence of position 2 modification with 3,3-diphenylalanine enantiomers. Highly potent V2 agonists. Eur J Med Chem. 2009;44(7):2862-2867. doi: https://doi.org/10.1016/j.ejmech.2008.12.010
15. Mikhaylova DS, Pigarova EA, Dzeranova LK. Drugs for the treatment of central diabetes insipidus: historical background and modern opportunities. Obesity and metabolism. 2017;14(1):17-23. (In Russ.). doi: https://doi.org/10.14341/omet2017117-23
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1. Figure 1. MRI of the patient's chiasmal-sellar area. Front cut. | |
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2. Figure 2. MRI of the patient's chiasmal-sellar area. Sagittal section. | |
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| Type | Исследовательские инструменты | |
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For citations:
Katamadze N.N., Pigarova E.A., Dzeranova L.K. Diagnosis and tactics of managing a patient with central diabetes insipidus on the example of a clinical case. Problems of Endocrinology. 2022;68(5):39-44. (In Russ.) https://doi.org/10.14341/probl13103
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