Loh Jennifer A, Verbalis Joseph G
Georgetown University-Washington Hospital Center Endocrinology and Metabolism Training Program, Washington, DC, USA.
Nat Clin Pract Endocrinol Metab. 2007 Jun;3(6):489-94. doi: 10.1038/ncpendmet0513.
A 28-year-old woman presented with new-onset vertigo and diplopia that had started 2 weeks previously. An MRI scan of the brain revealed an 11 x 9 x 9 mm sellar mass that extended into the suprasellar region. Evaluation of pituitary function showed mild central hypothyroidism and secondary adrenal insufficiency. The patient underwent trans-sphenoidal resection of the mass without any significant intraoperative complications. On postoperative day 1 she abruptly developed polyuria, hypernatremia and urine hypo-osmolality.
Measurements of plasma and urine osmolality, urine specific gravity, and serum sodium levels.
Postoperative diabetes insipidus with a triphasic pattern.
The patient's diabetes insipidus was initially treated with intravenous desmopressin, and her fluid status, serum sodium levels, and serum and urine osmolality were carefully monitored. During the second, antidiuretic phase, desmopressin was discontinued and the patient's fluid intake was restricted. After recurrence of diabetes insipidus during the third phase, the patient was treated with intranasal desmopressin and was discharged. She remains on desmopressin therapy for chronic diabetes insipidus.
一名28岁女性出现2周前开始的新发眩晕和复视。脑部MRI扫描显示一个11×9×9mm的鞍区肿块，延伸至鞍上区域。垂体功能评估显示轻度中枢性甲状腺功能减退和继发性肾上腺功能不全。患者接受了经蝶窦肿块切除术，术中无任何重大并发症。术后第1天，她突然出现多尿、高钠血症和低渗尿。
测定血浆和尿渗透压、尿比重及血清钠水平。
术后三相型尿崩症。
患者的尿崩症最初用静脉注射去氨加压素治疗，并密切监测其液体状态、血清钠水平以及血清和尿渗透压。在第二阶段（抗利尿期），停用去氨加压素并限制患者的液体摄入量。在第三阶段尿崩症复发后，患者接受鼻内去氨加压素治疗并出院。她仍接受去氨加压素治疗慢性尿崩症。
