Abstract:
Diabetes insipidus is a condition characterized by inappropriately dilute urine in the setting of serum hyperosmolality. The two predominant subtypes include central (from lack of vasopressin production) and nephrogenic diabetes insipidus (from renal resistance to circulating vasopressin). A common manifestation is the significant pursuant thirst from excessive polyuria. We present a case report and literature review of an infrequent variation of central diabetes insipidus known as adipsic (hypothalamic) diabetes insipidus, characterized by the absence of thirst, secondary to coiling of a ruptured anterior communicating artery aneurysm. Due to the loss of thirst, patients are at a heightened risk for hypernatremia and complications secondary to dehydration. Our patient\'s course was complicated by recurrent polyuria and hypernatremia, requiring a fixed-dose desmopressin regimen. On follow-up, only partial thirst sensation was restored. We provide a literature review to compare our case report to the scant literature available to broaden the awareness of this infrequent, perilous, manifestation.
摘要:
尿崩症是一种特征为在血清高渗透压下不适当稀释尿液的病症。两种主要亚型包括中枢型(缺乏加压素产生)和肾性尿崩症(从肾脏抵抗到循环加压素)。常见的表现是过量多尿引起的严重口渴。我们提供了一个病例报告和文献综述,该病例报告和文献综述了一种罕见的中央性尿崩症,称为脂肪(下丘脑)尿崩症,其特点是没有口渴,继发于破裂的前交通动脉瘤的盘绕。由于口渴的丧失,患者发生高钠血症和继发于脱水的并发症的风险增加.我们的病人的病程并发多尿和高钠血症,需要固定剂量去氨加压素方案。关于后续行动,只有部分口渴的感觉得以恢复。我们提供了文献综述,将我们的病例报告与现有的文献进行比较,以扩大对这种罕见的认识,危险,表现。