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1.
Electrolytes & Blood Pressure ; : 26-30, 2012.
Artigo em Inglês | WPRIM | ID: wpr-184820

RESUMO

We report a rare case of the concurrent manifestation of central diabetes insipidus (CDI) and type 2 diabetes mellitus (DM). A 56 year-old man was diagnosed as a type 2 DM on the basis of hyperglycemia with polyuria and polydipsia at a local clinic two months ago and started an oral hypoglycemic medication, but resulted in no symptomatic improvement at all. Upon admission to the university hospital, the patient's initial fasting blood sugar level was 140 mg/dL, and he showed polydipsic and polyuric conditions more than 8 L urine/day. Despite the hyperglycemia controlled with metformin and diet, his symptoms persisted. Further investigations including water deprivation test confirmed the coexisting CDI of unknown origin, and the patient's symptoms including an intense thirst were markedly improved by desmopressin nasal spray (10 microg/day). The possibility of a common origin of CDI and type 2 DM is raised in a review of the few relevant adult cases in the literature.


Assuntos
Adulto , Humanos , Glicemia , Desamino Arginina Vasopressina , Diabetes Insípido Neurogênico , Diabetes Mellitus Tipo 2 , Dieta , Jejum , Hiperglicemia , Metformina , Polidipsia , Poliúria , Sede , Privação de Água
2.
Electrolytes & Blood Pressure ; : 31-34, 2012.
Artigo em Inglês | WPRIM | ID: wpr-184819

RESUMO

We report a rare case of the concurrent manifestation of central diabetes insipidus (CDI) and type 2 diabetes mellitus (DM). A 56 year-old man was diagnosed as a type 2 DM on the basis of hyperglycemia with polyuria and polydipsia at a local clinic two months ago and started an oral hypoglycemic medication, but resulted in no symptomatic improvement at all. Upon admission to the university hospital, the patient's initial fasting blood sugar level was 140 mg/dL, and he showed polydipsic and polyuric conditions more than 8 L urine/day. Despite the hyperglycemia controlled with metformin and diet, his symptoms persisted. Further investigations including water deprivation test confirmed the coexisting CDI of unknown origin, and the patient's symptoms including an intense thirst were markedly improved by desmopressin nasal spray (10 microg/day). The possibility of a common origin of CDI and type 2 DM is raised in a review of the few relevant adult cases in the literature.


Assuntos
Adulto , Humanos , Glicemia , Desamino Arginina Vasopressina , Diabetes Insípido Neurogênico , Diabetes Mellitus Tipo 2 , Dieta , Jejum , Hiperglicemia , Metformina , Polidipsia , Poliúria , Sódio , Sede , Ácido Valproico , Privação de Água
3.
Arq. bras. endocrinol. metab ; 55(2): 171-174, mar. 2011. ilus, graf, tab
Artigo em Inglês | LILACS | ID: lil-586501

RESUMO

Sheehan's syndrome refers to the occurrence of hypopituitarism after delivery, usually preceded by postpartum hemorrhage. The condition still continues to be a common cause of hypopituitarism in developing countries like India. The disorder usually presents with anterior pituitary failure with preservation of posterior pituitary functions. Posterior pituitary dysfunction in the form of central diabetes insipidus is rare in patients with Sheehan's syndrome. We describe the clinical course of a young lady who after her sixth childbirth developed severe postpartum hemorrhage followed by development of panhypopituitarism which was confirmed by hormonal investigation and demonstration of empty sella on imaging. In addition, she developed Polyuria. The water deprivation test and response to vasopressin test results indicated central diabetes insipidus. She needed oral desmopressin on a continuous basis to control polyuria.


A síndrome de Sheehan está relacionada à ocorrência de hipopituitarismo pós-parto, geralmente precedido por hemorragia pós-parto. Essa condição clínica ainda constitui causa comum do hipopituitarismo observado em países em desenvolvimento como a Índia. Essa síndrome se caracteriza pela insuficiência da glândula hipofisária anterior, porém com a conservação das funções da glândula hipofisária posterior. A disfunção da hipófise posterior, sob a forma de diabetes insipidus central, é algo raramente observado em pacientes que apresentam a síndrome de Sheehan. Neste artigo, descrevemos o caso de uma jovem que, após o sexto parto, apresentou hemorragia pós-parto grave, seguida pela evolução de pan-hipopituitarismo que foi confirmado por pesquisa hormonal e exames de imagem que evidenciaram sela vazia. A jovem também apresentou poliúria. Os resultados do teste de privação de água e exame de resposta à vasopressina indicaram diabetes insípido central. A paciente fazia uso contínuo de desmopressina para controlar a poliúria.


Assuntos
Adulto , Feminino , Humanos , Gravidez , Diabetes Insípido Neurogênico/complicações , Hipopituitarismo/complicações , Hemorragia Pós-Parto/etiologia , Diabetes Insípido Neurogênico/diagnóstico , Hipopituitarismo/diagnóstico
4.
Journal of Korean Society of Endocrinology ; : 513-518, 2005.
Artigo em Coreano | WPRIM | ID: wpr-115700

RESUMO

Langerhans cell histiocytosis can cause central diabetes insipidus. Here, a case of Langerhans cell histiocytosis invading the pituitary stalk was experienced. The patient was 15 years old boy, with complaint of polydipsia and polyuria. A water deprivation test was carried out, and the urine osmolarity was increased from 165 to 469 mosm/kg following an injection of AVP to confirm the diagnosis of central diabetes insipidus. A pituitary function stimulation test gave a normal response. A sellar MRI was performed, which showed a thickened pituitary stalk mass (about 5.7mm), with an increased size, 6.9 mm, on a second MRI 2 month later. A tissue biopsy was performed, which showed aggregates of histiocytes and inflammatory cells, with prominent eosinophils (H&E), and also revealed strong reactivity to anti-CD1a antibody on the immunohistochemistry. After confirmative tissue diagnosis, the patient received radiotherapy (900 cGy). The thickened mass of the pituitary stalk disappeared on the MRI following the radiotherapy. The patient was managed with DDAVP nasal spray, after which the polyuric symptoms were completely relieved.


Assuntos
Adolescente , Humanos , Masculino , Biópsia , Desamino Arginina Vasopressina , Diabetes Insípido Neurogênico , Diagnóstico , Eosinófilos , Histiócitos , Histiocitose de Células de Langerhans , Imuno-Histoquímica , Imageamento por Ressonância Magnética , Concentração Osmolar , Hipófise , Polidipsia , Poliúria , Radioterapia , Privação de Água
5.
Chinese Journal of Endocrinology and Metabolism ; (12)1986.
Artigo em Chinês | WPRIM | ID: wpr-535131

RESUMO

Responses to water deprivation test of 27 children with growth retardation were obseived in an attempt to investigate their hypothalamic-posterior pituitary function, and as control, 13 cases of diabetes insipidus and 10 normal children were tested in the meantime. The results showed: 1) All GH deficient children presenting with polyuria and polydipsia had severe ADH deficiency; 2) In 11 GH deficient children without polyuria and polydipsia, 7 were found endogenous ADH insufficient; 3) The children with short stature, polyuria and polydipsia but a normal GH secretion were partial ADH deficient; 4) Hypothalamic-posterior pituitary function of the children with short stature but normal GH secretion and without polyuria and polydipsia %vas normal.We conclude that growth retarded children were proved more or less insufficient of ADH, thus the posterior pituitary function of growth retarded children should be investigated as well, that water deprivation test is an accurate and simple test for this purpose.

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