Central diabetes insipidus presenting as hyperglycemic hyperosmolar state : a case report /
Mendoza, Marie Christie MD.
Central diabetes insipidus presenting as hyperglycemic hyperosmolar state : a case report / Marie Christie Mendoza. - Fairview, Quezon City Department of Medicine, FEU-NRMF, 2006 - (in folder)
Includes appendices and bibliographical references.
ABSTRACT: This is a case of a 33 year old female with a chief complaint of lower extremity weakness, who had a 4-month history of polyuria, polydipsia and polyphagia, associated with dizziness and occasional blurring of vision. She was seen at the ER mildly dehydrated with blood pressure, CBG levels and serum sodium persistently elevated. Urine ketone was negative ruling out Diabetic Ketoacidosis in this patient. Management was focused on blood pressure and glycemic control, correction of electrolyte imbalance (hypernatremia, hypokalemia) and fluid replacement. During the course in the ward, noted were persistent polyuria with positive balance, hypernatremia with diluted urine and a low urine osmolality. Water deprivation test was done with 0.1 mg of Desmopressin. Result was consistent with Central Diabetes Insipidus, MRI of the brain and sella turcica revealed a tiny focus of delayed enhancement in the posterior pituitary gland which is highly suggestive of a pituitary microadenoma. Patient was sent home improved with antihypertensive medication, insulin and Desmopressin as her maintenance medication. With the problem of polyuria resolved by desmopression resolution of the elevated blood pressure and blood sugar followed.
Research - Department of Medicine
MED20060002
Central diabetes insipidus presenting as hyperglycemic hyperosmolar state : a case report / Marie Christie Mendoza. - Fairview, Quezon City Department of Medicine, FEU-NRMF, 2006 - (in folder)
Includes appendices and bibliographical references.
ABSTRACT: This is a case of a 33 year old female with a chief complaint of lower extremity weakness, who had a 4-month history of polyuria, polydipsia and polyphagia, associated with dizziness and occasional blurring of vision. She was seen at the ER mildly dehydrated with blood pressure, CBG levels and serum sodium persistently elevated. Urine ketone was negative ruling out Diabetic Ketoacidosis in this patient. Management was focused on blood pressure and glycemic control, correction of electrolyte imbalance (hypernatremia, hypokalemia) and fluid replacement. During the course in the ward, noted were persistent polyuria with positive balance, hypernatremia with diluted urine and a low urine osmolality. Water deprivation test was done with 0.1 mg of Desmopressin. Result was consistent with Central Diabetes Insipidus, MRI of the brain and sella turcica revealed a tiny focus of delayed enhancement in the posterior pituitary gland which is highly suggestive of a pituitary microadenoma. Patient was sent home improved with antihypertensive medication, insulin and Desmopressin as her maintenance medication. With the problem of polyuria resolved by desmopression resolution of the elevated blood pressure and blood sugar followed.
Research - Department of Medicine
MED20060002
