Diabetes insipidus causes: Difference between revisions

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| '''Miscellaneous'''
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|bgcolor="Beige"| [[Dehydration]] , [[Wolfram syndrome]] , [[Sicca syndrome]] , [[Septo-optic dysplasia]] , Infiltrative lesions , [[Idiopathic]] , [[Hand-Schuller-Christian Syndrome ]] ,Familial CDI , [[Erdheim-Chester disease]] , DIDMOAD syndrome , Anophthalmia -- hypyothalamo-pituitary insufficiency  , Anophthalmia -- hypothalamo-pituitary insufficiency  , [[Amyloidosis]]
|bgcolor="Beige"| [[Dehydration]] , [[Wolfram syndrome]] , [[Sicca syndrome]] , [[Septo-optic dysplasia]] , Infiltrative lesions , [[Idiopathic]] , [[Hand-Schuller-Christian Syndrome ]] , Familial CDI , [[Erdheim-Chester disease]] , DIDMOAD syndrome , Anophthalmia -- hypyothalamo-pituitary insufficiency  , Anophthalmia -- hypothalamo-pituitary insufficiency  , [[Amyloidosis]]


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Revision as of 03:20, 29 June 2013

Diabetes insipidus Microchapters

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

Causes

Central DI

The most common form of serious DI, central DI, results from damage to the pituitary gland, which disrupts the normal storage and release of ADH. Damage to the pituitary gland can be caused by different diseases as well as by head injuries, neurosurgery, or genetic disorders. To treat the ADH deficiency that results from any kind of damage to the hypothalamus or pituitary, a synthetic hormone called desmopressin can be taken by an injection, a nasal spray, or a pill. While taking desmopressin, a person should drink fluids only when thirsty and not at other times. The drug prevents water excretion, and water can build up now that the kidneys are making less urine and are less responsive to changes in body fluids.

Nephrogenic DI

Nephrogenic DI results when the kidneys are unable to respond to ADH. The kidneys’ ability to respond to ADH can be impaired by drugs—like lithium, for example—and by chronic disorders including polycystic kidney disease, sickle cell disease, kidney failure, partial blockage of the ureters, and inherited genetic disorders. Sometimes the cause of nephrogenic DI is never discovered. Desmopressin will not work for this form of DI. Instead, a person with nephrogenic DI may be given hydrochlorothiazide (HCTZ) or indomethacin. HCTZ is sometimes combined with another drug called amiloride. The combination of HCTZ and amiloride is sold under the brand name Moduretic. Again, with this combination of drugs, one should drink fluids only when thirsty and not at other times.

Dipsogenic DI

Dipsogenic DI is caused by a defect in or damage to the thirst mechanism, which is located in the hypothalamus. This defect results in an abnormal increase in thirst and fluid intake that suppresses ADH secretion and increases urine output. Desmopressin or other drugs should not be used to treat dipsogenic DI because they may decrease urine output but not thirst and fluid intake. This fluid overload can lead to water intoxication, a condition that lowers the concentration of sodium in the blood and can seriously damage the brain. Scientists have not yet found an effective treatment for dipsogenic DI.

Gestational DI

Gestational DI occurs only during pregnancy and results when an enzyme made by the placenta destroys ADH in the mother. The placenta is the system of blood vessels and other tissue that develops with the fetus. The placenta allows exchange of nutrients and waste products between mother and fetus.Most cases of gestational DI can be treated with desmopressin. In rare cases, however, an abnormality in the thirst mechanism causes gestational DI, and desmopressin should not be used.

Common causes

  • Idiopathic: 30% to 50% of all cases
  • Hypothalamic tumors, Pineal tumors

Causes by Organ System

Cardiovascular Hypovolemic shock
Chemical / poisoning No underlying causes
Dermatologic No underlying causes
Drug Side Effect Amphotericin B, Demeclocycline, Lithium , Radiation - for CNS and nasopharyngeal malignancies , Pituitary radiation , Netilmicin , Kanamycin, Carbamazepine , Amikacin
Ear Nose Throat No underlying causes
Endocrine Ischemia of the pitutary gland , Sheehan syndrome , Pituitary tumour , Panhypopituitarism , lymphocytic hypophysitis , Familial hypopituitarism , congenital nephrogenic , Congenital hypopituitarism , Apoplexy , pituitary cysts
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic Inherited genetic kidney disorders , Genetic diseases - pit-1 mutation
Hematologic Sickle cell disease , Langerhans cell histiocytosis
Iatrogenic Neurosurgery , Pituitary surgery
Infectious Disease Tuberculous meningitis , Meningoencephalitis , Infections
Musculoskeletal / Ortho No underlying causes
Neurologic Dipsogenic diabetes insipidus , Ischemic encephalopathy , Subarachnoid hemorrhage , Mass lesions hypothalamus , Ischemic stroke , Intracranial space-occupying lesion , Intracranial bleeding , Hypoxic encephalopathy , Hypothalamic radiation , Brain aneurysm
Nutritional / Metabolic Hypercalcemia , hemochromatosis , Anorexia nervosa
Obstetric/Gynecologic Gestational diabetes insipidus
Oncologic Pituitary Cancer , pituitary adenomas , malignant tumors infilterating hypothalamus from lung and breast , Histiocytosis , Craniopharyngioma
Opthalmologic No underlying causes
Overdose / Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal / Electrolyte Polycystic kidney disease, Renal failure , Interstitial nephritis , Hypokalaemia , Hypercalcaemia
Rheum / Immune / Allergy Sarcoidosis , Autoimmune Hypophysitis , Autoimmune Diabetes Insipidus
Sexual No underlying causes
Trauma Head injury , Trauma - fracture of skull base
Urologic Partial blockage of the ureters
Dental No underlying causes
Miscellaneous Dehydration , Wolfram syndrome , Sicca syndrome , Septo-optic dysplasia , Infiltrative lesions , Idiopathic , Hand-Schuller-Christian Syndrome , Familial CDI , Erdheim-Chester disease , DIDMOAD syndrome , Anophthalmia -- hypyothalamo-pituitary insufficiency , Anophthalmia -- hypothalamo-pituitary insufficiency , Amyloidosis

Causes in Alphabetical Order


References

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