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Abstract：
Lithium-induced nephrogenic diabetes insipidus (NDI) is a rare and difficult-to-treat condition. We describe the case of an 81-year-old woman with bipolar treated with lithium and no previous history of diabetes insipidus. She was hospitalized due to disturbance of consciousness and was diagnosed with, hypercalcemia, hyperparathyroidism, and NDI. Parathyroidectomy was contraindicated and parathyroid hormone level was improved insufficiently after cinacalcet initiation, percutaneous ethanol injection therapy was performed for the enlarged parathyroid gland. After improvement in hypercalcemia and unsuccessful indapamide treatment, triamterene was administrated to control polyuria. Lithium is one of the indispensable maintenance treatment options for bipolar disorder, but it has the side effect of NDI. Lithium enters the collecting duct\'s principal cells mainly via the epithelial sodium channel (ENaC) located on their apical membranes, ENaC shows high selectivity for both sodium and lithium, is upregulated by aldosterone, and inhibited by triamterene. To our knowledge, this is the first publication on triamterene use in lithium-induced NDI patients.
摘要：
锂引起的肾性尿崩症（NDI）是一种罕见且难以治疗的疾病。我们描述了一名81岁的双相女性患者，接受锂治疗，并且没有尿崩症病史。她因意识障碍住院，被诊断为，高钙血症,甲状旁腺功能亢进,和NDI。甲状旁腺切除术是禁忌的，西那卡塞开始后甲状旁腺激素水平改善不足，对增大的甲状旁腺进行经皮乙醇注射治疗。在改善高钙血症和不成功的茚达帕胺治疗后，给予氨苯蝶啶控制多尿。锂是双相情感障碍不可或缺的维持治疗选择之一，但它有NDI的副作用。锂主要通过位于其顶端膜上的上皮钠通道(ENaC)进入收集导管的主细胞。ENaC对钠和锂都显示出高选择性，被醛固酮上调，并被三氨蝶呤抑制。据我们所知,这是关于氨苯蝶啶在锂诱导的NDI患者中使用的第一份出版物.
