ABSTRACT
A 31-year-old man presented fatigue, polydipsia and polyuria. He was diagnosed as acute myelogenous leukemia (AML) FAB-M1, and a water deprivation test confirmed central diabetes insipidus (DI). A sella magnetic resonance imaging showed the thickening of pituitary stalk with contrast enhancement suggesting leukemic infiltration. He was treated with remission induction chemotherapy including cytosine arabinoside and idarubicin, and concurrent intrathecal methotrexate, cytosine arabinoside and hydrocortisone. But he was not achieved a remission. Reinduction chemotherapy was also failed to induce remission. He underwent a non-myeloablative allogeneic he matopoietic stem cell transplantation (NST) from HLA one antigen mismatched sibling donor for refractory AML. After transplantation, he had no evidence of leukemia and DI, He showed complete conversion of donor chimerism. By day 7 after NST, desmopressin (DDAVP) was no longer required and a follow-up at 9 months he has no evidence of relapse. We report a rare case recovered from diabetes insipidus associated with acute myelogenous leukemia after NST in Korea.
Subject(s)
Adult , Humans , Chimerism , Cytarabine , Deamino Arginine Vasopressin , Diabetes Insipidus , Diabetes Insipidus, Neurogenic , Drug Therapy , Fatigue , Follow-Up Studies , Hydrocortisone , Idarubicin , Korea , Leukemia , Leukemia, Myeloid, Acute , Leukemic Infiltration , Magnetic Resonance Imaging , Methotrexate , Pituitary Gland , Polydipsia , Polyuria , Recurrence , Remission Induction , Siblings , Stem Cell Transplantation , Stem Cells , Tissue Donors , Water DeprivationABSTRACT
Reports 41 cases of central diabetes insipidus (CDI) admited and treated during the 1 st 12 years.Some of the special clinical features. associated diseases,diagnosis and treatment are discussed.The clinical features of DI may be varied,the diagnosis of DI complicated with other dndocrine diseases may be difficult,pospond diagnosis and treatment may lead to a serious sequel.Owing to using CT scan the morbidity of primary DI may decrease.The drugs often used in treating DI are evaluated In conclusion these drugs not only are If no affect but also have some serious adverse effeets.Desmoprsin is nearly without appreciate-pressure-action especialy administrated orally.Desmopresin is proposed to be the best agent in treating DI up till now.