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| __NOTOC__ | | __NOTOC__ |
| {{Diabetes insipidus}} | | {{Diabetes insipidus}} |
| {{CMG}} | | {{CMG}}; {{AE}} {{DAMI}} |
| ==Overview== | | ==Overview== |
| Diabetes insipidus can be classified into 4; [[Central diabetes insipidus|central]], [[Nephrogenic diabetes insipidus|nephrogenic]], [[psychogenic]] and [[Gestational diabetes|gestational diabetes insipidus]]. It can also be classified 2; Disorders in which [[ADH]] levels are elevated and Disorders in which [[ADH]] levels may be appropriately suppressed'''<ref name="pmid25551526" />''' based on the levels of [[ADH]] present in the body and the levels of [[Hyponatremia|hypo]]- or [[hypernatremia]]. | | [[Diabetes insipidus]] can be classified into three types: [[central diabetes insipidus|central]], [[nephrogenic diabetes insipidus|nephrogenic]], and [[psychogenic]] diabetes insipidus. Some rare forms of the disease include [[Gestational age|gestational]] [[diabetes insipidus]], which occurs only in [[pregnancy]], and [[autoimmune]] diabetes insipidus, which is caused by an [[autoimmune]] reaction. |
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| ==Classification== | | ==Classification== |
| '''[[Central diabetes insipidus|Central DI]]''': [[CDI]] is caused by the destruction or degeneration of [[neurons]] originating in the [[Supraoptic nucleus|supraoptic]] and [[Paraventricular nucleus|paraventricular nuclei]]. [[Central diabetes insipidus|Central DI]], results from damage to the [[pituitary gland]], which disrupts the normal storage and release of [[ADH]]. The most common cause of [[central diabetes insipidus]] ([[CDI]]), accounting for the vast majority of cases, are [[idiopathic]] [[diabetes insipidus]] (DI)<ref name="pmid6640507">{{cite journal| author=Kimmel DW, O'Neill BP| title=Systemic cancer presenting as diabetes insipidus. Clinical and radiographic features of 11 patients with a review of metastatic-induced diabetes insipidus. | journal=Cancer | year= 1983 | volume= 52 | issue= 12 | pages= 2355-8 | pmid=6640507 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6640507 }} </ref><ref name="pmid11018166">{{cite journal| author=Maghnie M, Cosi G, Genovese E, Manca-Bitti ML, Cohen A, Zecca S et al.| title=Central diabetes insipidus in children and young adults. | journal=N Engl J Med | year= 2000 | volume= 343 | issue= 14 | pages= 998-1007 | pmid=11018166 | doi=10.1056/NEJM200010053431403 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11018166 }} </ref>. Others include<ref name="pmid11018166">{{cite journal| author=Maghnie M, Cosi G, Genovese E, Manca-Bitti ML, Cohen A, Zecca S et al.| title=Central diabetes insipidus in children and young adults. | journal=N Engl J Med | year= 2000 | volume= 343 | issue= 14 | pages= 998-1007 | pmid=11018166 | doi=10.1056/NEJM200010053431403 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11018166 }} </ref>; | | ==='''[[Central diabetes insipidus|Central DI]]'''=== |
| *[[Familial]] and [[congenital disease]]
| | *[[CDI]] is caused by the destruction or degeneration of [[neurons]] originating in the [[Supraoptic nucleus|supraoptic]] and [[Paraventricular nucleus|paraventricular nuclei]], which disrupts the normal storage and release of [[ADH]]. |
| **[[Familial]] [[CDI]]<ref name="pmid11427695">{{cite journal| author=Burbach JP, Luckman SM, Murphy D, Gainer H| title=Gene regulation in the magnocellular hypothalamo-neurohypophysial system. | journal=Physiol Rev | year= 2001 | volume= 81 | issue= 3 | pages= 1197-267 | pmid=11427695 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11427695 }} </ref>
| | *The most common cause of [[central diabetes insipidus]] ([[CDI]]) is [[idiopathic]] [[diabetes insipidus]] (DI), which accounts for the vast majority of cases of CDI.<ref name="pmid6640507">{{cite journal| author=Kimmel DW, O'Neill BP| title=Systemic cancer presenting as diabetes insipidus. Clinical and radiographic features of 11 patients with a review of metastatic-induced diabetes insipidus. | journal=Cancer | year= 1983 | volume= 52 | issue= 12 | pages= 2355-8 | pmid=6640507 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6640507 }} </ref><ref name="pmid11018166">{{cite journal| author=Maghnie M, Cosi G, Genovese E, Manca-Bitti ML, Cohen A, Zecca S et al.| title=Central diabetes insipidus in children and young adults. | journal=N Engl J Med | year= 2000 | volume= 343 | issue= 14 | pages= 998-1007 | pmid=11018166 | doi=10.1056/NEJM200010053431403 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11018166 }} </ref> |
| **[[Wolfram syndrome]] also known as DIDMOAD ([[diabetes insipidus]], [[diabetes mellitus]], [[optic atrophy]], and [[deafness]])<ref name="pmid26025012">{{cite journal| author=Bischoff AN, Reiersen AM, Buttlaire A, Al-Lozi A, Doty T, Marshall BA et al.| title=Selective cognitive and psychiatric manifestations in Wolfram Syndrome. | journal=Orphanet J Rare Dis | year= 2015 | volume= 10 | issue= | pages= 66 | pmid=26025012 | doi=10.1186/s13023-015-0282-1 | pmc=4450481 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26025012 }} </ref>
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| **Congenital hypopituitarism<ref name="pmid8157716">{{cite journal| author=Yagi H, Nagashima K, Miyake H, Tamai S, Onigata K, Yutani S et al.| title=Familial congenital hypopituitarism with central diabetes insipidus. | journal=J Clin Endocrinol Metab | year= 1994 | volume= 78 | issue= 4 | pages= 884-9 | pmid=8157716 | doi=10.1210/jcem.78.4.8157716 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8157716 }} </ref>
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| **[[Septo-optic dysplasia]]<ref name="pmid4191531">{{cite journal| author=Hoyt WF, Kaplan SL, Grumbach MM, Glaser JS| title=Septo-optic dysplasia and pituitary dwarfism. | journal=Lancet | year= 1970 | volume= 1 | issue= 7652 | pages= 893-4 | pmid=4191531 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4191531 }} </ref>
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| *[[Neurosurgery]] or [[trauma]]<ref name="pmid2492841">{{cite journal| author=Seckl J, Dunger D| title=Postoperative diabetes insipidus. | journal=BMJ | year= 1989 | volume= 298 | issue= 6665 | pages= 2-3 | pmid=2492841 | doi= | pmc=1835326 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2492841 }} </ref><ref name="pmid16235676">{{cite journal| author=Nemergut EC, Zuo Z, Jane JA, Laws ER| title=Predictors of diabetes insipidus after transsphenoidal surgery: a review of 881 patients. | journal=J Neurosurg | year= 2005 | volume= 103 | issue= 3 | pages= 448-54 | pmid=16235676 | doi=10.3171/jns.2005.103.3.0448 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16235676 }} </ref>
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| *[[Cancer]]<ref name="pmid6640507">{{cite journal| author=Kimmel DW, O'Neill BP| title=Systemic cancer presenting as diabetes insipidus. Clinical and radiographic features of 11 patients with a review of metastatic-induced diabetes insipidus. | journal=Cancer | year= 1983 | volume= 52 | issue= 12 | pages= 2355-8 | pmid=6640507 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6640507 }} </ref>
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| *[[Hypoxic encephalopathy]]
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| *Infiltrative disorders<ref name="pmid20434166">{{cite journal| author=Grois N, Fahrner B, Arceci RJ, Henter JI, McClain K, Lassmann H et al.| title=Central nervous system disease in Langerhans cell histiocytosis. | journal=J Pediatr | year= 2010 | volume= 156 | issue= 6 | pages= 873-81, 881.e1 | pmid=20434166 | doi=10.1016/j.jpeds.2010.03.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20434166 }} </ref><ref name="pmid2797079">{{cite journal| author=Dunger DB, Broadbent V, Yeoman E, Seckl JR, Lightman SL, Grant DB et al.| title=The frequency and natural history of diabetes insipidus in children with Langerhans-cell histiocytosis. | journal=N Engl J Med | year= 1989 | volume= 321 | issue= 17 | pages= 1157-62 | pmid=2797079 | doi=10.1056/NEJM198910263211704 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2797079 }} </ref>
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| **[[Langerhans cell histiocytosis]] (LCH)
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| **[[Eosinophilic granuloma]]
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| *[[Supraventricular tachycardia|Post-supraventricular tachycardia]]<ref name="pmid6434116">{{cite journal| author=Canepa-Anson R, Williams M, Marshall J, Mitsuoka T, Lightman S, Sutton R| title=Mechanism of polyuria and natriuresis in atrioventricular nodal tachycardia. | journal=Br Med J (Clin Res Ed) | year= 1984 | volume= 289 | issue= 6449 | pages= 866-8 | pmid=6434116 | doi= | pmc=1443391 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6434116 }} </ref>
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| *[[Anorexia nervosa]]<ref name="pmid6835335">{{cite journal| author=Gold PW, Kaye W, Robertson GL, Ebert M| title=Abnormalities in plasma and cerebrospinal-fluid arginine vasopressin in patients with anorexia nervosa. | journal=N Engl J Med | year= 1983 | volume= 308 | issue= 19 | pages= 1117-23 | pmid=6835335 | doi=10.1056/NEJM198305123081902 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6835335 }} </ref>
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| '''[[Nephrogenic diabetes insipidus|Nephrogenic DI]]''': The most common causes of [[ADH]] resistance severe enough to produce [[polyuria]] are hereditary nephrogenic DI in children, and chronic [[lithium]] ingestion and [[hypercalcemia]] in adults. Acquired causes are often partially reversible with cessation of the offending drug or correction of [[hypercalcemia]]. Other causes include; | | ==='''[[Nephrogenic diabetes insipidus|Nephrogenic DI]]'''=== |
| *Hereditary [[nephrogenic diabetes insipidus]]<ref name="pmid10477148">{{cite journal| author=van Lieburg AF, Knoers NV, Monnens LA| title=Clinical presentation and follow-up of 30 patients with congenital nephrogenic diabetes insipidus. | journal=J Am Soc Nephrol | year= 1999 | volume= 10 | issue= 9 | pages= 1958-64 | pmid=10477148 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10477148 }} </ref>
| | *The most common causes of [[ADH]] resistance severe enough to produce [[polyuria]] are hereditary nephrogenic DI (in children) and chronic [[lithium]] ingestion and [[hypercalcemia]] (in adults). |
| **[[Vasopressin]] V2 receptor gene mutations<ref name="pmid15004257">{{cite journal| author=Sasaki S| title=Nephrogenic diabetes insipidus: update of genetic and clinical aspects. | journal=Nephrol Dial Transplant | year= 2004 | volume= 19 | issue= 6 | pages= 1351-3 | pmid=15004257 | doi=10.1093/ndt/gfh172 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15004257 }} </ref><ref name="pmid9329382">{{cite journal| author=Nomura Y, Onigata K, Nagashima T, Yutani S, Mochizuki H, Nagashima K et al.| title=Detection of skewed X-inactivation in two female carriers of vasopressin type 2 receptor gene mutation. | journal=J Clin Endocrinol Metab | year= 1997 | volume= 82 | issue= 10 | pages= 3434-7 | pmid=9329382 | doi=10.1210/jcem.82.10.4312 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9329382 }} </ref>
| | *Acquired causes are often partially reversible with cessation of the offending drug or correction of [[hypercalcemia]].<ref name="pmid10477148">{{cite journal| author=van Lieburg AF, Knoers NV, Monnens LA| title=Clinical presentation and follow-up of 30 patients with congenital nephrogenic diabetes insipidus. | journal=J Am Soc Nephrol | year= 1999 | volume= 10 | issue= 9 | pages= 1958-64 | pmid=10477148 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10477148 }} </ref><ref name="pmid15004257">{{cite journal| author=Sasaki S| title=Nephrogenic diabetes insipidus: update of genetic and clinical aspects. | journal=Nephrol Dial Transplant | year= 2004 | volume= 19 | issue= 6 | pages= 1351-3 | pmid=15004257 | doi=10.1093/ndt/gfh172 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15004257 }} </ref><ref name="pmid3037155">{{cite journal| author=Berl T| title=The cAMP system in vasopressin-sensitive nephron segments of the vitamin D-treated rat. | journal=Kidney Int | year= 1987 | volume= 31 | issue= 5 | pages= 1065-71 | pmid=3037155 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3037155 }} </ref> |
| **Aquaporin-2 gene mutation<ref name="pmid15153548">{{cite journal| author=Devonald MA, Karet FE| title=Renal epithelial traffic jams and one-way streets. | journal=J Am Soc Nephrol | year= 2004 | volume= 15 | issue= 6 | pages= 1370-81 | pmid=15153548 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15153548 }} </ref>
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| *[[Lithium]] toxicity<ref name="pmid19384328">{{cite journal| author=Grünfeld JP, Rossier BC| title=Lithium nephrotoxicity revisited. | journal=Nat Rev Nephrol | year= 2009 | volume= 5 | issue= 5 | pages= 270-6 | pmid=19384328 | doi=10.1038/nrneph.2009.43 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19384328 }} </ref>
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| *[[Hypercalcemia]]<ref name="pmid3037155">{{cite journal| author=Berl T| title=The cAMP system in vasopressin-sensitive nephron segments of the vitamin D-treated rat. | journal=Kidney Int | year= 1987 | volume= 31 | issue= 5 | pages= 1065-71 | pmid=3037155 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3037155 }} </ref>
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| *[[Hypokalemia]]<ref name="pmid26674602">{{cite journal| author=Khositseth S, Uawithya P, Somparn P, Charngkaew K, Thippamom N, Hoffert JD et al.| title=Autophagic degradation of aquaporin-2 is an early event in hypokalemia-induced nephrogenic diabetes insipidus. | journal=Sci Rep | year= 2015 | volume= 5 | issue= | pages= 18311 | pmid=26674602 | doi=10.1038/srep18311 | pmc=4682130 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26674602 }} </ref>, Persistent severe [[hypokalemia]] (plasma [[Potassium-aggravated myotonia|potassium]] concentration usually below 3 meq/L) can impair urinary concentrating ability
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| *Other — [[Nephrogenic diabetes insipidus|Nephrogenic DI]] has been described in a number of other clinical settings
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| **[[Renal]] disease
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| ***[[Sickle-cell disease|Sickle cell disease]] or trait
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| ***[[Autosomal dominant polycystic kidney disease]]
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| ***[[Medullary cystic kidney disease]]
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| ***[[Amyloidosis|Renal amyloidosis]]<ref name="pmid13807843">{{cite journal| author=CARONE FA, EPSTEIN FH| title=Nephrogenic diabetes insipidus caused by amyloid disease. Evidence in man of the role of the collecting ducts in concentrating urine. | journal=Am J Med | year= 1960 | volume= 29 | issue= | pages= 539-44 | pmid=13807843 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13807843 }} </ref>
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| ***[[Sjögren's syndrome]]<ref name="pmid14320699">{{cite journal| author=SHEARN MA, TU WH| title=NEPHROGENIC DIABETIC INSIPIDUS AND OTHER DEFECTS OF RENAL TUBULAR FUNCTION IN SJOERGREN'S SYNDROME. | journal=Am J Med | year= 1965 | volume= 39 | issue= | pages= 312-8 | pmid=14320699 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14320699 }} </ref>
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| **Drugs<ref name="pmid15806465">{{cite journal| author=Garofeanu CG, Weir M, Rosas-Arellano MP, Henson G, Garg AX, Clark WF| title=Causes of reversible nephrogenic diabetes insipidus: a systematic review. | journal=Am J Kidney Dis | year= 2005 | volume= 45 | issue= 4 | pages= 626-37 | pmid=15806465 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15806465 }} </ref>
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| ***[[Cidofovir]]
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| ***[[Foscarnet]]
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| ***[[Amphotericin B]]
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| ***[[Demeclocycline]]
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| ***[[Ifosfamide]]
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| ***[[Ofloxacin]]
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| ***Orlistat
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| ***Didanosine
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| **Pregnancy<ref name="pmid15863571">{{cite journal| author=Brewster UC, Hayslett JP| title=Diabetes insipidus in the third trimester of pregnancy. | journal=Obstet Gynecol | year= 2005 | volume= 105 | issue= 5 Pt 2 | pages= 1173-6 | pmid=15863571 | doi=10.1097/01.AOG.0000161811.02155.68 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15863571 }} </ref>
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| **Bardet-Biedl syndrome<ref name="pmid8270381">{{cite journal| author=Anadoliiska A, Roussinov D| title=Clinical aspects of renal involvement in Bardet-Biedl syndrome. | journal=Int Urol Nephrol | year= 1993 | volume= 25 | issue= 5 | pages= 509-14 | pmid=8270381 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8270381 }} </ref>
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| **Bartter syndrome<ref name="pmid11893344">{{cite journal| author=Peters M, Jeck N, Reinalter S, Leonhardt A, Tönshoff B, Klaus G Gü et al.| title=Clinical presentation of genetically defined patients with hypokalemic salt-losing tubulopathies. | journal=Am J Med | year= 2002 | volume= 112 | issue= 3 | pages= 183-90 | pmid=11893344 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11893344 }} </ref>
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| '''Psychogenic Diabetes insipidus''' | | ==='''Psychogenic Diabetes Insipidus'''=== |
| | *This type of [[DI]] is characterized primarily by excessive water intake. This disorder is most often observed among young women and mentally unstable patients with [[Psychiatric illness|psychiatric illnesses]], including those taking a [[phenothiazine]], which can lead to the sensation of a dry mouth.<ref name="pmid15153548">{{cite journal| author=Devonald MA, Karet FE| title=Renal epithelial traffic jams and one-way streets. | journal=J Am Soc Nephrol | year= 2004 | volume= 15 | issue= 6 | pages= 1370-81 | pmid=15153548 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15153548 }} </ref> |
| | *Other identifiable causes of psychogenic diabetes insipidus include [[sarcoidosis]] and [[lesions]] to the [[Hypothalamic pituitary adrenal axis|hypothalamic pituitary axis]], which may disrupt the thirst center, thereby increasing the sensation of [[thirst]] and water consumption.<ref name="pmid9329382">{{cite journal| author=Nomura Y, Onigata K, Nagashima T, Yutani S, Mochizuki H, Nagashima K et al.| title=Detection of skewed X-inactivation in two female carriers of vasopressin type 2 receptor gene mutation. | journal=J Clin Endocrinol Metab | year= 1997 | volume= 82 | issue= 10 | pages= 3434-7 | pmid=9329382 | doi=10.1210/jcem.82.10.4312 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9329382 }} </ref> |
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| '''Gestational Diabetes insipidus''' | | ==='''Gestational Diabetes Insipidus'''=== |
| | *This type of [[diabetes insipidus]] occurs only during [[pregnancy]]. Gestational DI occurs when an [[enzyme]] made by the [[placenta]] destroys [[ADH]] produced in the mother. |
| | *Most cases of gestational DI can be successfully treated with [[desmopressin]].<ref name="pmid15153548" /> |
| | *In rare cases, however, an abnormality in the thirst mechanism causes gestational DI, and [[desmopressin]] should not be used.<ref name="pmid19384328">{{cite journal| author=Grünfeld JP, Rossier BC| title=Lithium nephrotoxicity revisited. | journal=Nat Rev Nephrol | year= 2009 | volume= 5 | issue= 5 | pages= 270-6 | pmid=19384328 | doi=10.1038/nrneph.2009.43 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19384328 }} </ref> |
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| | | ==='''Autoimmune Diabetes Insipidus'''=== |
| | | *This type of [[diabetes insipidus]] is very rare. It results from an [[autoimmune]] cause.<ref name="pmid9329382" /> |
| === Differentiating Diabetes insipidus based on the levels of ADH and the response of the body to the level of hyponatremia === | | *It is usually associated with other [[autoimmune]] diseases and typically affects women of childbearing age.<ref name="pmid9329382" /> |
| *'''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>
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| **Reduced effective arterial blood volume | |
| ***True volume depletion
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| ***Heart failure
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| ***Cirrhosis
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| **Syndrome of inappropriate ADH secretion, including reset osmostat pattern
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| **Hormonal changes
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| ***Adrenal insufficiency
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| ***Hypothyroidism
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| ***Pregnancy
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| *'''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>'''
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| **Advanced renal failure
| |
| **Primary polydipsia
| |
| **Beer drinker's potomania
| |
| **Diabetes mellitus
| |
| **Sickle cell disease
| |
| | |
| *'''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> | |
| **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== | | ==References== |