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Leelaviwat N, Benjanuwattra J, Elkheshen A, Eshak N, Elmassry M, Abdelnabi M. Transient diabetes insipidus after vasopressin discontinuation in cystic fibrosis with septic shock. Proc AMIA Symp 2022; 36:118-120. [PMID: 36578627 PMCID: PMC9762782 DOI: 10.1080/08998280.2022.2111645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Central diabetes insipidus (DI) is an uncommon condition caused by reduced or lack of vasopressin secretion from the posterior pituitary gland, typically caused by gland destruction. Several other causes for central DI have also been proposed. Here we present a case of transient central DI after discontinuation of vasopressin used for septic shock without evidence of overt pituitary damage in a cystic fibrosis patient. The serum sodium concentration peaked at 137 mmol/L in the setting of polyuria within 3 days of vasopressin discontinuation without other identified alternative etiologies. Sodium levels and urine output trended down dramatically with desmopressin administration.
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Affiliation(s)
- Natnicha Leelaviwat
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Juthipong Benjanuwattra
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Ahmed Elkheshen
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Nouran Eshak
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Marawan Elmassry
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Mahmoud Abdelnabi
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas,Cardiology and Angiology Unit, Clinical and Experimental Internal Medicine Department, Medical Research Institute, Alexandria University, Alexandria, Egypt,Corresponding author: Mahmoud Hassan Abdelnabi, MD, MSc, Department of Internal Medicine, Texas Tech University Health Sciences Center, 3601 4th St., Lubbock, TX79430 (e-mail: )
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Transient central diabetes insipidus during prolonged sinus surgery: case report and literature review. OTOLARYNGOLOGY CASE REPORTS 2020. [DOI: 10.1016/j.xocr.2019.100139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Nasa P, Varma G, Kulkarni A, Chaudhary S, Sagar P. Central Diabetes Insipidus in an Off-pump Coronary Artery Bypass Grafting Surgery. Indian J Crit Care Med 2020. [PMID: 31911744 DOI: 10.5005/jp-journals-10071-23278.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Polyuria in perioperative coronary artery bypass grafting (CABG) surgery is common and mostly benign. Diabetes insipidus (DI) post-CABG is however very rare and mostly have been related with use of cardiopulmonary bypass (CPB) pump. The patient recovered completely with transient requirement of exogenous vasopressin. The central DI may be considered as a differential diagnosis in case of polyuria in the perioperative period of CABG surgery. How to cite this article Nasa P, Varma G, Kulkarni A, Chaudhary S, Sagar P. Central Diabetes Insipidus in an Off-pump Coronary Artery Bypass Grafting Surgery. IJCCM 2019;23(11):523-525.
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Affiliation(s)
- Prashant Nasa
- Department of Critical Care and ICU, NMC Specialty Hospital, Al Nahda, Dubai, United Arab Emirates
| | - Girishchandra Varma
- Department of Cardiac Sciences, NMC Specialty Hospital, Al Nahda, Dubai, United Arab Emirates
| | - Amitabh Kulkarni
- Department of Nephrology, NMC Specialty Hospital, Al Nahda, Dubai, United Arab Emirates
| | - Sandeep Chaudhary
- Department of Endocrinology, Diabetology and Metabolic Disorders, NMC Specialty Hospital, Al Nahda, Dubai, United Arab Emirates
| | - Prashant Sagar
- Department of Anaesthesiology, NMC Specialty Hospital, Al Nahda, Dubai, United Arab Emirates
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Nasa P, Varma G, Kulkarni A, Chaudhary S, Sagar P. Central Diabetes Insipidus in an Off-pump Coronary Artery Bypass Grafting Surgery. Indian J Crit Care Med 2019; 23:523-525. [PMID: 31911744 PMCID: PMC6900895 DOI: 10.5005/jp-journals-10071-23278] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
UNLABELLED Polyuria in perioperative coronary artery bypass grafting (CABG) surgery is common and mostly benign. Diabetes insipidus (DI) post-CABG is however very rare and mostly have been related with use of cardiopulmonary bypass (CPB) pump. The patient recovered completely with transient requirement of exogenous vasopressin. The central DI may be considered as a differential diagnosis in case of polyuria in the perioperative period of CABG surgery. HOW TO CITE THIS ARTICLE Nasa P, Varma G, Kulkarni A, Chaudhary S, Sagar P. Central Diabetes Insipidus in an Off-pump Coronary Artery Bypass Grafting Surgery. IJCCM 2019;23(11):523-525.
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Affiliation(s)
- Prashant Nasa
- Department of Critical Care and ICU, NMC Specialty Hospital, Al Nahda, Dubai, United Arab Emirates
- Prashant Nasa, Department of Critical Care and ICU, NMC Specialty Hospital, Al Nahda, Dubai, United Arab Emirates, Phone: +971-91-11-25572115, e-mail:
| | - Girishchandra Varma
- Department of Cardiac Sciences, NMC Specialty Hospital, Al Nahda, Dubai, United Arab Emirates
| | - Amitabh Kulkarni
- Department of Nephrology, NMC Specialty Hospital, Al Nahda, Dubai, United Arab Emirates
| | - Sandeep Chaudhary
- Department of Endocrinology, Diabetology and Metabolic Disorders, NMC Specialty Hospital, Al Nahda, Dubai, United Arab Emirates
| | - Prashant Sagar
- Department of Anaesthesiology, NMC Specialty Hospital, Al Nahda, Dubai, United Arab Emirates
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Jang KM, Sohn YS, Hwang YJ, Choi BS, Cho MH. Deficiency of antidiuretic hormone: a rare cause of massive polyuria after kidney transplantation. KOREAN JOURNAL OF PEDIATRICS 2016; 59:202-4. [PMID: 27186232 PMCID: PMC4865645 DOI: 10.3345/kjp.2016.59.4.202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 05/28/2014] [Accepted: 07/19/2014] [Indexed: 11/27/2022]
Abstract
A 15-year-old boy, who was diagnosed with Alport syndrome and end-stage renal disease, received a renal transplant from a living-related donor. On postoperative day 1, his daily urine output was 10,000 mL despite normal graft function. His laboratory findings including urine, serum osmolality, and antidiuretic hormone levels showed signs similar to central diabetes insipidus, so he was administered desmopressin acetate nasal spray. After administering the desmopressin, urine specific gravity and osmolality increased abruptly, and daily urine output declined to the normal range. The desmopressin acetate was tapered gradually and discontinued 3 months later. Graft function was good, and urine output was maintained within the normal range without desmopressin 20 months after the transplantation. We present a case of a massive polyuria due to transient deficiency of antidiuretic hormone with the necessity of desmopressin therapy immediately after kidney transplantation in a pediatric patient.
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Affiliation(s)
- Kyung Mi Jang
- Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
| | - Young Soo Sohn
- Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
| | - Young Ju Hwang
- Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
| | - Bong Seok Choi
- Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
| | - Min Hyun Cho
- Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
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Abstract
Central Diabetes Insipidus (CDI) following ischemic infarction of the brain has been described as a rare presentation. Posterior pituitary ischemia has also been postulated as a possible cause of idiopathic CDI. We encountered a young male with bilateral extensive ischemic infarction sustained at high altitude, who had transient polyuria due to central diabetes insipidus, requiring desmopressin therapy. DI completely resolved during the course of his neurological recovery.
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Affiliation(s)
- Muthukrishnan Jayaraman
- Department of Medicine, Command Hoapital (Western Command), Chandimandir, Panchkula, Haryana, India
| | - Sandeep Kumar
- Department of Medicine, Command Hoapital (Western Command), Chandimandir, Panchkula, Haryana, India
| | - F. M. H. Ahmad
- Department of Medicine, Command Hoapital (Western Command), Chandimandir, Panchkula, Haryana, India
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