Diabetes insipidus

Changed by Bruno Di Muzio, 5 Sep 2017

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Diabetes insipidus (DI) is the deficiency or resistance to the hormone vasopressin (antidiuretic hormone), which results in polyuria and polydipsia.

Epidemiology

DI occurs in 3 per 100,000 people ².

Pathology

DI may be described as ^1-3:

central/neurogenic/hypothalamic: vasopressin deficient (more common)
peripheral/nephrogenic: vasopressin resistant

Aetiology

central DI: reduced secretion of vasopressin
- trauma
- neurosurgery
- malignancy, e.g. craniopharyngioma, germinoma, metastases
- autoimmune disease, e.g. lymphocytic hypophysitis
- inflammatory disease, e.g. sarcoidosis, Langerhans cell histiocytosis, IgG4-related
- infection, e.g. tuberculosis
- pregnancy
- familial (rare)
- idiopathic
peripheral DI: increased end-organ resistance to vasopressin
- congenital renal insensitivity to vasopressin (rare)
- long-term lithium use (15% of patients)
- metabolic, e.g. hypokalaemia, hypercalcaemia
- chronic kidney disease
- pregnancy

Treatment and prognosis

Desmopressin can be used to treat central DI ⁴.

-<li>inflammatory disease, e.g. <a href="/articles/neurosarcoidosis">sarcoidosis</a>, <a href="/articles/langerhans-cell-histiocytosis">Langerhans cell histiocytosis</a>, <a href="/articles/igg4-related-sclerosing-disease-1">IgG4-related</a>
+<li>inflammatory disease, e.g. <a href="/articles/neurosarcoidosis">sarcoidosis</a>, <a href="/articles/langerhans-cell-histiocytosis">Langerhans cell histiocytosis</a>, <a href="/articles/igg4-related-disease">IgG4-related</a>

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