Barnett Maxim J, Patel Goonja, Lekprasert Patamaporn, Win Kay, Casipit Carlo, Syed Osama
Internal Medicine, Jefferson Einstein Hospital, Philadelphia, USA.
Endocrinology, Jefferson Einstein Hospital, Philadelphia, USA.
Cureus. 2024 Jul 10;16(7):e64207. doi: 10.7759/cureus.64207. eCollection 2024 Jul.
Diabetes insipidus is a condition characterized by inappropriately dilute urine in the setting of serum hyperosmolality. The two predominant subtypes include central (from lack of vasopressin production) and nephrogenic diabetes insipidus (from renal resistance to circulating vasopressin). A common manifestation is the significant pursuant thirst from excessive polyuria. We present a case report and literature review of an infrequent variation of central diabetes insipidus known as adipsic (hypothalamic) diabetes insipidus, characterized by the absence of thirst, secondary to coiling of a ruptured anterior communicating artery aneurysm. Due to the loss of thirst, patients are at a heightened risk for hypernatremia and complications secondary to dehydration. Our patient's course was complicated by recurrent polyuria and hypernatremia, requiring a fixed-dose desmopressin regimen. On follow-up, only partial thirst sensation was restored. We provide a literature review to compare our case report to the scant literature available to broaden the awareness of this infrequent, perilous, manifestation.
尿崩症是一种在血清高渗情况下以尿液过度稀释为特征的病症。两种主要亚型包括中枢性尿崩症（因抗利尿激素分泌不足）和肾性尿崩症（因肾脏对循环中的抗利尿激素产生抵抗）。一个常见表现是因多尿导致的强烈继发口渴感。我们报告一例病例并进行文献综述，该病例为中枢性尿崩症的一种罕见变异型，即无渴感（下丘脑性）尿崩症，其特征为无口渴感，继发于破裂的前交通动脉瘤的盘绕。由于口渴感缺失，患者发生高钠血症及脱水继发并发症的风险增加。我们患者的病程因反复出现多尿和高钠血症而复杂化，需要固定剂量的去氨加压素治疗方案。随访时，仅部分口渴感得以恢复。我们进行文献综述，将我们的病例报告与现有的少量文献进行比较，以提高对这种罕见且危险表现的认识。
