Differentiating Diabetes insipidus from other diseases: Difference between revisions

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==Differentiating Diabetes insipidus from other Diseases==  
==Differentiating Diabetes insipidus from other Diseases==  
*Disorders in which ADH levels are elevated<ref name="pmid25078421">{{cite journal| author=Danziger J, Zeidel ML| title=Osmotic homeostasis. | journal=Clin J Am Soc Nephrol | year= 2015 | volume= 10 | issue= 5 | pages= 852-62 | pmid=25078421 | doi=10.2215/CJN.10741013 | pmc=4422250 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25078421  }} </ref>
**Reduced effective arterial blood volume
***True volume depletion
***Heart failure
***Cirrhosis
**Syndrome of inappropriate ADH secretion, including reset osmostat pattern
**Hormonal changes
***Adrenal insufficiency
***Hypothyroidism
***Pregnancy


===[[Nephrogenic Diabetes Insipidus]]===
*Disorders in which ADH levels may be appropriately suppressed<ref name="pmid25551526">{{cite journal| author=Sterns RH| title=Disorders of plasma sodium--causes, consequences, and correction. | journal=N Engl J Med | year= 2015 | volume= 372 | issue= 1 | pages= 55-65 | pmid=25551526 | doi=10.1056/NEJMra1404489 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25551526  }} </ref>
* Acute tubular necrosis
**Advanced renal failure
* [[Amyloidosis]]
**Primary polydipsia
* Drugs
**Beer drinker's potomania
* Genetic
* Granuloma
* [[Ddx:Hypercalcemia|Hypercalcemia]]
* [[Ddx:Hyperkalemia|Hyperkalemia]]
* Polycystic kidneys
* Pregnancy
* Sarcoma
* [[Sickle Cell Disease]]
* Urinary tract obstruction


===[[Pituitary Diabetes Insipidus]]===
*Hyponatremia with normal or elevated plasma osmolality<ref name="pmid24722436">{{cite journal| author=Fenske WK, Christ-Crain M, Hörning A, Simet J, Szinnai G, Fassnacht M et al.| title=A copeptin-based classification of the osmoregulatory defects in the syndrome of inappropriate antidiuresis. | journal=J Am Soc Nephrol | year= 2014 | volume= 25 | issue= 10 | pages= 2376-83 | pmid=24722436 | doi=10.1681/ASN.2013080895 | pmc=4178436 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24722436  }} </ref>
* [[Adenoma]]s
**High plasma osmolality (effective osmols)
* [[Aneurysm]]
***Hyperglycemia
* [[Aortocoronary bypass]]
***Mannitol
* Chemical toxins
**High plasma osmolality (ineffective osmols)
* Congenital pituitary malformations
***Renal failure
* Craniopharyngeoma
***Alcohol intoxication with an elevated serum alcohol concentration
* [[Encephalitis]]
**Normal plasma osmolality
* Genetic
***Pseudohyponatremia (laboratory artifact)
* [[Granuloma]]s
****High triglycerides
* Head trauma
****Cholestatic and obstructive jaundice (lipoprotein-X)
* [[Hypoxic encephalopathy]]
****Multiple myeloma
* [[Leukemia]]
***Absorption of irrigant solutions
* [[Lymphoma]]
****Glycine
* Lymphocytic neurohypophysitis
****Sorbitol
* [[Meningitis]]
****Mannitol
* [[Metastase]]s
* Posthypophysectomy
* [[Sarcoidosis]]
* [[Scleroderma]]
* [[Sheehan's Syndrome]]
* [[Stroke]]
* [[Systemic Lupus Erythematosus]]
* [[Toxoplasmosis]]
* [[Tuberculosis]]
* [[Wegener's Granulomatosis]]
 
===Primary Polydipsia===
* Drugs
* Granulomas
* Head trauma
* Iatrogenic
* [[Multiple Sclerosis]]
* [[Obsessive-Compulsive Disorder]]
* [[Schizophrenia]]
* [[Tuberculosis]]


==References==
==References==

Revision as of 18:08, 11 July 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Diabetes insipidus must be differentiated from other diseases that cause polyuria which is defined as a urine output exceeding 3 L/day in adults and 2 L/m2 in children, increased frequency or nocturia and polydipsia.

Differentiating Diabetes insipidus from other Diseases

  • Disorders in which ADH levels are elevated[1]
    • Reduced effective arterial blood volume
      • True volume depletion
      • Heart failure
      • Cirrhosis
    • Syndrome of inappropriate ADH secretion, including reset osmostat pattern
    • Hormonal changes
      • Adrenal insufficiency
      • Hypothyroidism
      • Pregnancy
  • Disorders in which ADH levels may be appropriately suppressed[2]
    • Advanced renal failure
    • Primary polydipsia
    • Beer drinker's potomania
  • Hyponatremia with normal or elevated plasma osmolality[3]
    • High plasma osmolality (effective osmols)
      • Hyperglycemia
      • Mannitol
    • High plasma osmolality (ineffective osmols)
      • Renal failure
      • Alcohol intoxication with an elevated serum alcohol concentration
    • Normal plasma osmolality
      • Pseudohyponatremia (laboratory artifact)
        • High triglycerides
        • Cholestatic and obstructive jaundice (lipoprotein-X)
        • Multiple myeloma
      • Absorption of irrigant solutions
        • Glycine
        • Sorbitol
        • Mannitol

References

  1. Danziger J, Zeidel ML (2015). "Osmotic homeostasis". Clin J Am Soc Nephrol. 10 (5): 852–62. doi:10.2215/CJN.10741013. PMC 4422250. PMID 25078421.
  2. Sterns RH (2015). "Disorders of plasma sodium--causes, consequences, and correction". N Engl J Med. 372 (1): 55–65. doi:10.1056/NEJMra1404489. PMID 25551526.
  3. Fenske WK, Christ-Crain M, Hörning A, Simet J, Szinnai G, Fassnacht M; et al. (2014). "A copeptin-based classification of the osmoregulatory defects in the syndrome of inappropriate antidiuresis". J Am Soc Nephrol. 25 (10): 2376–83. doi:10.1681/ASN.2013080895. PMC 4178436. PMID 24722436.

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