Martini G, Filosomi G, Valenti R, Lunghetti S, Pallavicino D, Nuti R
Cattedra di Medicina Interna (OPD), Istituto di Patologia Medica, Università, Siena.
Recenti Prog Med. 1998 Sep;89(9):450-3.
We report a case of central diabetes insipidus with spontaneous remission 8 months after clinical beginning of the disease. A 20 years-old man developed polydipsia and polyuria in October 1994. A water deprivation study showed a defect in the urine concentrating function, which was corrected by vasopressine. A Magnetic Resonance imaging of the skull revealed a thickening of the pituitary stalk. His condition was well controlled by nasal DDAVP administration and 6 months later patient reduced spontaneously medication dose without clinical worsening. 8 months after clinical beginning, patient has become completely free from the need for medication to control clinical symptoms and urine concentrating function, as demonstrated by a re-evaluation study with water deprivation. A control Magnetic Resonance showed the regression of stalk enlargement. The clinical and radiological features of this case are discussed.
我们报告一例中枢性尿崩症患者,在疾病临床起病8个月后出现自发缓解。一名20岁男性于1994年10月出现烦渴和多尿。禁水试验显示尿液浓缩功能存在缺陷,给予血管加压素后该缺陷得到纠正。头颅磁共振成像显示垂体柄增粗。通过鼻腔给予去氨加压素,他的病情得到了良好控制,6个月后患者自行减少了药物剂量,且临床症状未加重。临床起病8个月后,通过再次禁水评估研究表明,患者已完全无需药物来控制临床症状和尿液浓缩功能。对照磁共振显示垂体柄增粗消退。本文讨论了该病例的临床和影像学特征。