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突然停用血管加压素导致短暂性中枢性尿崩症:一例报告

Sudden Vasopressin Withdrawal Causing Transient Central Diabetes Insipidus: A Case Report.

作者信息

Pata Ramakanth, Nway Nway, Logvinsky Ilana K, Lutaya Innocent, Chowdhury Tutul

机构信息

Pulmonary and Critical Care Medicine, One Brooklyn Health, New York, USA.

Pulmonary and Critical Care Medicine, University of Cincinnati Medical Center, Cincinatti, USA.

出版信息

Cureus. 2022 May 13;14(5):e24966. doi: 10.7759/cureus.24966. eCollection 2022 May.

Abstract

Vasopressin is a peptide hormone produced by the hypothalamus and stored in the posterior pituitary. It is secreted in response to hypotension and hyperosmolarity. Vasopressin and its analogs have been widely used in vasodilatory shocks such as septic shock and cardiogenic shock. The sudden withdrawal of vasopressin after its prolonged use can lead to polyuria and rising sodium levels, which is concerning for the diagnosis of diabetic insipidus (DI); likely central rather than nephrogenic in origin. We present a case of diabetic insipidus following the sudden discontinuation of a prolonged vasopressin infusion for septic shock, which responded to tapering doses of desmopressin.

摘要

血管加压素是一种由下丘脑产生并储存于垂体后叶的肽类激素。它在低血压和高渗状态下分泌。血管加压素及其类似物已广泛应用于脓毒性休克和心源性休克等血管舒张性休克。长期使用血管加压素后突然停药可导致多尿和血钠水平升高,这对于尿崩症(DI)的诊断至关重要;其病因可能是中枢性而非肾源性。我们报告一例因脓毒性休克长期输注血管加压素后突然停药导致的尿崩症病例,该病例对逐渐减量的去氨加压素治疗有反应。

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