Differentiating Diabetes insipidus from other diseases

Jump to navigation Jump to search

Diabetes insipidus Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Diabetes insipidus from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic study of choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-Ray

CT scan

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Differentiating Diabetes insipidus from other diseases On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Differentiating Diabetes insipidus from other diseases

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Differentiating Diabetes insipidus from other diseases

CDC on Differentiating Diabetes insipidus from other diseases

Differentiating Diabetes insipidus from other diseases in the news

Blogs on Differentiating Diabetes insipidus from other diseases

Directions to Hospitals Treating Diabetes insipidus

Risk calculators and risk factors for Differentiating Diabetes insipidus from other diseases

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Diabetes insipidus must be differentiated from other diseases that cause polyuria which is defined as a urine output exceeding 3 L/day in adults and 2 L/m2 in children, increased frequency or nocturia and polydipsia. It is important to know that levels of hypo or hypernatremia is not sufficient to describe the underlying cause of diabetes insipidus.

Differentiating Diabetes insipidus from other Diseases

Differentiating diabetes insipidus based on the type of diabetes insipidus caused

  • Central diabetes insipidus
    • Acquired
      • Trauma (surgery, deceleration injury)
      • Vascular (cerebral hemorrhage, infarction, anterior communicating artery aneurysm or ligation, intrahypothalamic hemorrhage)
      • Neoplastic (craniopharyngioma, meningioma, germinoma, pituitary tumor or metastases)
      • Granulomatous (histiocytosis, sarcoidosis)
      • Infectious (meningitis, encephalitis)
      • Inflammatory/autoimmune (lymphocytic infundibuloneurohypophysitis)
      • Drug/toxin-induced (ethanol, diphenylhydantoin, snake venom)
      • Other disorders (hydrocephalus, ventricular/suprasellar cyst, trauma, degenerative diseases)
      • Idiopathic
    • Congenital
      • Congenital malformations
        • Autosomal dominant: AVP-neurophysin gene mutations
        • Autosomal recessive [1][2]: Wolfram Syndrome (DIDMOAD) [3]
        • X-linked recessive
      • Idiopathic
  • Nephrogenic diabetes insipidus
    • Acquired
      • Drug-induced (demeclocycline, lithium, cisplatin, methoxyflurane, etc.)
      • Hypercalcemia, hypokalemia
      • Infiltrating lesions (sarcoidosis, amyloidosis, multiple myeloma, Sjoergen's disease)
      • Vascular (sickle cell disease)
    • Congenital
      • X-linked recessive (OMIM 304800): AVP V2 receptor gene mutations
      • Autosomal recessive: AQP2 water channel gene mutations
  • Primary polydipsia
    • Psychogenic
    • Dipsogenic (downward resetting of thirst threshold)
  • Gestational Diabetes insipidus
  • Diabetes meliitus
Type of DI Subclass Disease Defining signs and symptoms Lab findings Treatment
Central Acquired Histiocytosis
  • Bone lysis and fracture
  • Purulent otitis media
  • Diabetes insipidus and delayed puberty
  • Maxillary, mandibular, and gingival disease
  • Rash and maculoerythematous skin lesions
  • Scaly, erythematous scalp patches
  • Lung involvement
  • GI bleeding
  • Lymph node enlargement[4]
Craniopharyngioma
  • Headache
  • Endocrine dysfunction
    • Diabetes insipidus
    • Hypothyroidism
    • Adrenal failure
    • Diabetes insipidus (eg, excessive fluid intake and urination)
    • Growth failure and delayed puberty
Sarcoidosis
  • Systemic complaints
    • Fever
    • Anorexia
    • Arthralgias
  • Pulmonary complaints
    • Dyspnea on exertion
    • Cough
    • Chest pain,
    • Hemoptysis (rare)
  • Diabetes mellitus
Hydrocephalus
  • Cognitive deterioration
  • Headaches
  • Neck pain
  • Blurred vision
  • Unsteady gait
  • Incontinence such as polyuria
Congenital AVP-neurophysin gene mutations
Wolfram Syndrome (DIDMOAD)
  • Diabetes Insipidus
  • Diabetes Mellitus
  • Optic Atrophy
  • Deafness
Nephrogenic Acquired Drug-induced (demeclocycline, lithium)
  • Polyuria
  • Polydipsia
  • Nocturia
Hypercalcemia
  • Polyuria
  • Polydipsia
  • Gastrointestinal disturbances
  • Pathological fractures
  • Confusion
  • Palpitations and cardiac arrhythmias
Hypokalemia
  • Polyuria
  • Hyporeflexia
  • Palpitations and cardiac arrhythmias
Amyloidosis
Multiple myeloma
Sickle cell disease
Congenital AVP V2 receptor gene mutations
AQP2 water channel gene mutations
Primary polydipsia Psychogenic
Pregnancy Gestational diabetes insipidus
Diabetes mellitus

References

  1. Willcutts MD, Felner E, White PC (1999). "Autosomal recessive familial neurohypophyseal diabetes insipidus with continued secretion of mutant weakly active vasopressin". Hum Mol Genet. 8 (7): 1303–7. PMID 10369876.
  2. Abu Libdeh A, Levy-Khademi F, Abdulhadi-Atwan M, Bosin E, Korner M, White PC; et al. (2010). "Autosomal recessive familial neurohypophyseal diabetes insipidus: onset in early infancy". Eur J Endocrinol. 162 (2): 221–6. doi:10.1530/EJE-09-0772. PMID 19897608.
  3. Barrett TG, Bundey SE (1997). "Wolfram (DIDMOAD) syndrome". J Med Genet. 34 (10): 838–41. PMC 1051091. PMID 9350817.
  4. Ghosh KN, Bhattacharya A (1992). "Gonotrophic nature of Phlebotomus argentipes (Diptera: Psychodidae) in the laboratory". Rev Inst Med Trop Sao Paulo. 34 (2): 181–2. PMID 1340034.

Template:WH Template:WS