Central diabetes insipidus: a case from real clinical practice


DOI: https://dx.doi.org/10.18565/therapy.2020.8.135-141

Ushanova F.O., Demidova T.Yu.

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow
Central diabetes insipidus is a severe neuroendocrine disease associated with a decrease in the secretion of vasopressin and resulting in the release of excess amounts of unconcentrated urine. Excessive fluid loss in diabetes insipidus can lead to dehydration of the body and a disturbance in the electrolyte composition of the blood, which, if untreated, can be life-threatening to the patient. Treatment of the disease is based on replacement therapy with desmopressin and is aimed primarily at reducing the severity of symptoms of the disease. At the same time, adherence to an adequate drinking regime corresponding to fluid loss is of great importance for maintaining an adequate water-electrolyte balance in central diabetes insipidus. This article will describe a clinical case of a long course of central diabetes insipidus, which for many years was compensated only by the consumption of large volumes of water by the patient, the decompensation of which occurred with the addition of type 2 diabetes mellitus.
Keywords: vasopressin, polydipsia, polyuria, diabetes insipidus, desmopressin, antidiuretic hormone, central diabetes insipidus
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Literature


  1. Дедов И.И., Мельниченко Г.А., Пигарова Е.А. с соавт. Федеральные клинические рекомендации по диагностике и лечению несахарного диабета у взрослых. Ожирение и метаболизм. 2018; 2: 56–71. [Dedov I.I., Melnichenko G.A., Pigarova E.A. et al. Federal clinical guidelines on diagnosis and treatment of diabetes insipidus in adults. Ozhirenie i metabolizm. 2018; 2: 56–71 (In Russ.)]. doi: 10.14341/omet9670

  2. Refardt J. Diagnosis and differential diagnosis of diabetes insipidus: update. Best Pract Res Clin Endocrinol Metab. 2020; 101398. doi: 10.1016/j.beem.2020.101398.

  3. Анциферов М.Б., Маркина Н.В. Центральный несахарный диабет: современные представления и лечебные подходы. Фарматека. 2011; 3: 60–64. [Antsiferov M.B., Markina N.V. Central diabetes insipidus: modern concepts and therapeutic approaches. Farmateka. 2011; 3: 60–64 (In Russ.)].

  4. Nayak P., Montaser A.S., Hu J. et al. Predictors of postoperative diabetes insipidus following endoscopic resection of pituitary adenomas. J Endocr Soc. 2018; 2(9): 1010–19. doi: 10.1210/js.2018-00121.

  5. Valenti G., Tamma G. History of diabetes insipidus. G Ital Nefrol. 2016; 33 Suppl 66: 33.S66.1.

  6. Du Vigneaud V. Hormones of the posterior pituitary gland: oxytocin and vasopressin. Harvey Lect. 1954–1955; 50: 1–26.

  7. Knepper M.A., Ingelfinger J.R., Kwon T.-H., Nielsen S. Molecular physiology of water balance. N Engl J Med. 2015; 372(14): 1349–58. doi: 10.1056/NEJMra1404726.

  8. Tian Y. Downregulation of renal vasopressin V2 receptor and aquaporin-2 expression parallels age-associated defects in urine concentration. Am J Physiol Renal Physiol. 2004; 287(4): F797–F805. doi: 10.1152/ajprenal.00403.2003.

  9. Пигарова Е.А., Дзеранова Л.К. Диагностика и лечение центрального несахарного диабета. Ожирение и метаболизм. 2014; 4; 48–55. [Pigarova E.A., Dzeranova L.K. Diagnosis and treatment of central diabetes insipidus. Ozhirenie i metabolizm. 2014; 4; 48–55 (In Russ.)]. doi: 10.14341/OMET2014448-55.

  10. Liu S.Y., Tung Y.C., Lee C.T. et al. Clinical characteristics of central diabetes insipidus in Taiwanese children. J Formos Med Assoc. 2013; 112(10): 616–20. doi: 10.1016/j.jfma.2013.06.019.

  11. Дзеранова Л.К., Пигарова Е.А. Несахарный диабет. Эндокринология: Национальное руководство. Под ред. Дедова И.И., Мельниченко Г.А. 2-е изд., переработанное и дополненное. М.: ГЭОТАР-Медиа. 2016; с. 804–809. [Dzeranova L.K., Pigarova E.A. Diabetes insipidus. Endocrinology: National guidelines. Ed. by Dedov I.I., Melnichenko G.A. M.: GEOTAR-Media. 2016; pp. 804–809 (In Russ.)].

  12. Vande Walle J., Stockner M., Raes A., Norgaard J. Desmopressin 30 years in clinical use: a safety review. Current Drug Safety. 2007; 2(3): 232–38. doi: 10.2174/157488607781668891.

  13. Lottmann H., Froeling F., Alloussi S. et al. A randomised comparison of oral desmopressin lyophilisate (MELT) and tablet formulations in children and adolescents with primary nocturnal enuresis. Int J Clin Pract. 2007; 61(9): 1454–60. doi: 10.1111/j.1742-1241.2007.01493.x.

  14. Juul K.V., Schroeder M., Rittig S., Norgaard J.P. National surveillance of central diabetes insipidus (CDI) in Denmark: results from 5 years registration of 9309 prescriptions of desmopressin to 1285 CDI patients. J Clin Endocr Metab. 2014; 99(6): 2181–87. doi: 10.1210/jc.2013-4411.

  15. Бирюкова E.В. Выбор препаратов десмопрессина для лечения центрального несахарного диабета. Ожирение и метаболизм. 2017; 4: 23–30. [Biryukova E.V. Selection of desmopressin preparations for the treatment of central diabetes insipidus. Ozhirenie i metabolizm. 2017; 4: 23–30 (In Russ.)]. doi: 10.14341/omet2017423-30.


About the Autors

Fatima O. Ushanova, assistant of the Department of endocrinology, faculty of general medicine of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityaninova Str. Tel.: +7 (925) 011-10-10. E-mail: fati_2526@mail.ru
Tatyana Yu. Demidova, MD, professor, head of the Department of endocrinology, faculty of general medicine of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 109263, Moscow, 4/1 Shkuleva Str. E-mail: t.y.demidova@gmail.com. ORCID: 0000-0001-6385-540X


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