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==
Central diabetes insipidus
Acquired
[[Trauma]] ([[surgery]], deceleration injury)
[[Vascular]] ([[cerebral hemorrhage]], [[infarction]], [[anterior communicating artery aneurysm]] or [[ligation]], intra-hypothalamic [[hemorrhage]])
[[Neoplastic]] ([[craniopharyngioma]], [[meningioma]], [[germinoma]], [[pituitary tumor]] or [[Metastasis|metastases]])
[[Granulomatous]] ([[histiocytosis]], [[sarcoidosis]])
[[Infectious]] ([[meningitis]], [[encephalitis]])
[[Inflammatory]]/[[autoimmune]] ([[lymphocytic]] infundibuloneurohypophysitis)
[[Drug]]/[[toxin]]-induced ([[ethanol]], [[diphenylhydantoin]], snake venom)
Other disorders ([[hydrocephalus]], ventricular/[[suprasellar]] cyst, [[trauma]], [[degenerative diseases]])
[[Idiopathic]]
[[Congenital disorder|Congenital]]
[[Congenital malformations]]
[[Autosomal dominant|Autosomal dominant:]] AVP-neurophysin gene mutations
[[Autosomal recessive]]
[[X-linked recessive]]
[[Idiopathic]]
Nephrogenic diabetes insipidus
[[Acquired disorder|Acquired]]
Drug-induced ([[demeclocycline]], [[lithium]], [[cisplatin]], [[methoxyflurane]], etc.)
[[Hypercalcemia]], [[hypokalemia]]
Infiltrating lesions ([[sarcoidosis]], [[amyloidosis]], [[multiple myeloma]], [[Sjögren's syndrome|Sjogren's disease]])
[[Vascular]] ([[Sickle-cell disease|sickle cell disease]])
Congenital
[[X-linked recessive]] (OMIM 304800): AVP V2 receptor gene mutations
[[Autosomal recessive]]: AQP2 water channel gene mutations
Primary polydipsia
[[Psychogenic]]
Dipsogenic (downward resetting of thirst threshold)
Gestational diabetes insipidus
[[Diabetes mellitus]]
== Differentiating diabetes insipidus based on the type of diabetes insipidus caused ==
<ref name="pmid10369876">{{cite journal| author=Willcutts MD, Felner E, White PC| title=Autosomal recessive familial neurohypophyseal diabetes insipidus with continued secretion of mutant weakly active vasopressin. | journal=Hum Mol Genet | year= 1999 | volume= 8 | issue= 7 | pages= 1303-7 | pmid=10369876 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10369876  }} </ref><ref name="pmid19897608">{{cite journal| author=Abu Libdeh A, Levy-Khademi F, Abdulhadi-Atwan M, Bosin E, Korner M, White PC et al.| title=Autosomal recessive familial neurohypophyseal diabetes insipidus: onset in early infancy. | journal=Eur J Endocrinol | year= 2010 | volume= 162 | issue= 2 | pages= 221-6 | pmid=19897608 | doi=10.1530/EJE-09-0772 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19897608  }} </ref> [[Wolfram syndrome|Wolfram Syndrome]] (DIDMOAD)<ref name="pmid9350817">{{cite journal| author=Barrett TG, Bundey SE| title=Wolfram (DIDMOAD) syndrome. | journal=J Med Genet | year= 1997 | volume= 34 | issue= 10 | pages= 838-41 | pmid=9350817 | doi= | pmc=1051091 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9350817  }} </ref>


=== Differentiating diabetes insipidus based on the type of diabetes insipidus caused ===
*'''Central diabetes insipidus'''
**Acquired
***[[Trauma]] ([[surgery]], deceleration injury)
***[[Vascular]] ([[cerebral hemorrhage]], [[infarction]], [[anterior communicating artery aneurysm]] or [[ligation]], intra-hypothalamic [[hemorrhage]])
***[[Neoplastic]] ([[craniopharyngioma]], [[meningioma]], [[germinoma]], [[pituitary tumor]] or [[Metastasis|metastases]])
***[[Granulomatous]] ([[histiocytosis]], [[sarcoidosis]])
***[[Infectious]] ([[meningitis]], [[encephalitis]])
***[[Inflammatory]]/[[autoimmune]] ([[lymphocytic]] infundibuloneurohypophysitis)
***[[Drug]]/[[toxin]]-induced ([[ethanol]], [[diphenylhydantoin]], snake venom)
***Other disorders ([[hydrocephalus]], ventricular/[[suprasellar]] cyst, [[trauma]], [[degenerative diseases]])
***[[Idiopathic]]
**[[Congenital disorder|Congenital]]
***[[Congenital malformations]]
****[[Autosomal dominant|Autosomal dominant:]] AVP-neurophysin gene mutations
****[[Autosomal recessive]]:<ref name="pmid10369876">{{cite journal| author=Willcutts MD, Felner E, White PC| title=Autosomal recessive familial neurohypophyseal diabetes insipidus with continued secretion of mutant weakly active vasopressin. | journal=Hum Mol Genet | year= 1999 | volume= 8 | issue= 7 | pages= 1303-7 | pmid=10369876 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10369876  }} </ref><ref name="pmid19897608">{{cite journal| author=Abu Libdeh A, Levy-Khademi F, Abdulhadi-Atwan M, Bosin E, Korner M, White PC et al.| title=Autosomal recessive familial neurohypophyseal diabetes insipidus: onset in early infancy. | journal=Eur J Endocrinol | year= 2010 | volume= 162 | issue= 2 | pages= 221-6 | pmid=19897608 | doi=10.1530/EJE-09-0772 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19897608  }} </ref> [[Wolfram syndrome|Wolfram Syndrome]] (DIDMOAD)<ref name="pmid9350817">{{cite journal| author=Barrett TG, Bundey SE| title=Wolfram (DIDMOAD) syndrome. | journal=J Med Genet | year= 1997 | volume= 34 | issue= 10 | pages= 838-41 | pmid=9350817 | doi= | pmc=1051091 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9350817  }} </ref>
****[[X-linked recessive]]
***[[Idiopathic]]
*'''Nephrogenic diabetes insipidus'''
**[[Acquired disorder|Acquired]]
***Drug-induced ([[demeclocycline]], [[lithium]], [[cisplatin]], [[methoxyflurane]], etc.)
***[[Hypercalcemia]], [[hypokalemia]]
***Infiltrating lesions ([[sarcoidosis]], [[amyloidosis]], [[multiple myeloma]], [[Sjögren's syndrome|Sjogren's disease]])
***[[Vascular]] ([[Sickle-cell disease|sickle cell disease]])
**Congenital
***[[X-linked recessive]] (OMIM 304800): AVP V2 receptor gene mutations
***[[Autosomal recessive]]: AQP2 water channel gene mutations
*'''Primary polydipsia'''
**[[Psychogenic]]
**Dipsogenic (downward resetting of thirst threshold)
*'''Gestational diabetes insipidus'''
*'''[[Diabetes mellitus]]'''
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==References==
==References==
{{reflist|2}}
{{reflist|2}}

Revision as of 20:38, 27 October 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Omodamola Aje B.Sc, M.D. [2]

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 urine frequency, or nocturia; and polydipsia. It is important to know that levels of hypo- or hypernatremia is not sufficient to describe the underlying cause of diabetes insipidus.

Differentiating Diabetes insipidus from other Diseases

Central diabetes insipidus Acquired Trauma (surgery, deceleration injury) Vascular (cerebral hemorrhage, infarction, anterior communicating artery aneurysm or ligation, intra-hypothalamic hemorrhage) Neoplastic (craniopharyngioma, meningioma, germinoma, pituitary tumor or metastases) Granulomatous (histiocytosis, sarcoidosis) Infectious (meningitis, encephalitis) Inflammatory/autoimmune (lymphocytic infundibuloneurohypophysitis) Drug/toxin-induced (ethanol, diphenylhydantoin, snake venom) Other disorders (hydrocephalus, ventricular/suprasellar cyst, trauma, degenerative diseases) Idiopathic Congenital Congenital malformations Autosomal dominant: AVP-neurophysin gene mutations Autosomal recessive X-linked recessive Idiopathic Nephrogenic diabetes insipidus Acquired Drug-induced (demeclocycline, lithium, cisplatin, methoxyflurane, etc.) Hypercalcemia, hypokalemia Infiltrating lesions (sarcoidosis, amyloidosis, multiple myeloma, Sjogren's disease) Vascular (sickle cell disease) Congenital X-linked recessive (OMIM 304800): AVP V2 receptor gene mutations Autosomal recessive: AQP2 water channel gene mutations Primary polydipsia Psychogenic Dipsogenic (downward resetting of thirst threshold) Gestational diabetes insipidus Diabetes mellitus

Differentiating diabetes insipidus based on the type of diabetes insipidus caused

[1][2] Wolfram Syndrome (DIDMOAD)[3]

Type of DI Subclass Disease Defining signs and symptoms Lab/Imaging findings
Central Acquired Histiocytosis
  • CD1a and CD45 +
  • Interleukin-17 (ILITA)
Skull x-ray of a patient with Langerhan's histiocytosis showing lytic lesions - Case courtesy of Dr Hani Salam, Radiopaedia.org, rID: 9459
Craniopharyngioma
Brain MRI showing suprasellar mass consistent with the diagnosis of craniopharyngioma - Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 16812
Sarcoidosis
Contrast-enhanced patches in a patient previously diagnosed with lung sarcoidosis - Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 10930
Congenital Hydrocephalus Dilated ventricles on CT and MRI
Obstructive hydrocephalus showing dilated lateral ventricles - Case courtesy of Dr Paul Simkin, Radiopaedia.org, rID: 30453
Wolfram Syndrome (DIDMOAD)
Nephrogenic Acquired Drug-induced (demeclocycline, lithium)
Hypercalcemia
  • Ca levels greater than 11 meq/L
Hypokalemia
  • K levels less than 3meq/L on CBC
Multiple myeloma
Skeletal survey in a patient with multiple myeloma showing multiple lytic lesions - Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 7682
Sickle cell disease
Blood film showing the sickle cells - By Dr Graham Beards - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=18421017
Primary polydipsia Psychogenic
Gestational diabetes insipidus
Diabetes mellitus
  • Elevated blood sugar levels >126
  • Elevated HbA1c > 6.5

References

  1. Willcutts MD, Felner E, White PC (1999). "Autosomal recessive familial neurohypophyseal diabetes insipidus with continued secretion of mutant weakly active vasopressin". Hum Mol Genet. 8 (7): 1303–7. PMID 10369876.
  2. Abu Libdeh A, Levy-Khademi F, Abdulhadi-Atwan M, Bosin E, Korner M, White PC; et al. (2010). "Autosomal recessive familial neurohypophyseal diabetes insipidus: onset in early infancy". Eur J Endocrinol. 162 (2): 221–6. doi:10.1530/EJE-09-0772. PMID 19897608.
  3. Barrett TG, Bundey SE (1997). "Wolfram (DIDMOAD) syndrome". J Med Genet. 34 (10): 838–41. PMC 1051091. PMID 9350817.
  4. Ghosh KN, Bhattacharya A (1992). "Gonotrophic nature of Phlebotomus argentipes (Diptera: Psychodidae) in the laboratory". Rev Inst Med Trop Sao Paulo. 34 (2): 181–2. PMID 1340034.

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