García-Ruiz Víctor Raúl, Suárez-Rojas Jacsel, Álvarez-Gamero Julio César, Paz-Ibarra José Luis
Seguro Social de Salud (EsSalud), Hospital Nacional Edgardo Rebagliati Martins, Servicio de Endocrinología. Lima, Perú.
Rev Med Inst Mex Seguro Soc. 2020 Nov 4;58(6):740-745. doi: 10.24875/RMIMSS.M20000108.
Adipsic diabetes insipidus is a rare condition secondary to injury to osmoreceptors in the anterior hypothalamic area. Only two cases have been published secondary to pituitary tumor surgery.
A 43-year-old man, postoperative of a non-functioning pituitary macroadenoma invading the third ventricle and compressing the hypothalamus. Reoperated for headache and rhinorrhachia, developing diabetes insipidus in the postoperative period was discharged with 20 μg/day nasal desmopressin. He came again due to sensorial disorder and hypernatremia, managing to control with intravenous hydration and desmopressin. It presents with recurrence of hypernatremia every time intravenous hydration is suspended and taken orally. With high sodium levels, there is an absence of thirst. A diagnosis of adipsic diabetes insipidus is made, indicating supervised administration of water orally with favorable evolution.
Adipsic diabetes insipidus is a rare variant of central diabetes insipidus caused by damage to osmoreceptors in the hypothalamus. It manifests with absence of perception of thirst, hypernatremia and polyuria. Its management is complex and requires strict control of the water balance and adherence to treatment.
失水性尿崩症是一种继发于下丘脑前部区域渗透压感受器损伤的罕见病症。仅有两例继发于垂体肿瘤手术的病例被报道。
一名43岁男性，因无功能垂体大腺瘤侵犯第三脑室并压迫下丘脑而接受手术。因头痛和鼻衄再次手术，术后出现尿崩症，出院时使用20μg/天的鼻腔去氨加压素。他因感觉障碍和高钠血症再次前来就诊，通过静脉补液和去氨加压素得以控制。每次暂停静脉补液并改为口服给药时，高钠血症都会复发。血钠水平升高时，患者无口渴感。诊断为失水性尿崩症，表明需监督患者口服补水，病情进展良好。
失水性尿崩症是中枢性尿崩症的一种罕见变体，由下丘脑渗透压感受器受损引起。其表现为无口渴感、高钠血症和多尿。其治疗复杂，需要严格控制水平衡并坚持治疗。
