Nephrogenic diabetes insipidus presenting after head trauma.
Water diuresis after head trauma is most often due to central diabetes insipidus (DI). We report a patient with a history of a bipolar disorder and past lithium use who was noted to have polyuria and hypernatremia after head trauma. Inappropriate high sodium and volume replacement resulted in an increase in the polyuria. A lack of response to antidiuretic hormone/antidiuretic-hormone-like preparations led to the diagnosis of nephrogenic DI. The case illustrates the importance of calculating electrolyte-free osmolar clearance in the correction of hypernatremia. Persistence of the DI and mild renal impairment probably due to past lithium use are discussed.
Trivedi
H S
HS
Department of Internal Medicine, University of Missouri, Columbia 65212.
Nolph
K D
KD
D000328:Adult; D001714:Bipolar Disorder / Q000150:complications / Q000188:drug therapy; D006259:Craniocerebral Trauma / Q000150:complications*; D003919:Diabetes Insipidus / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D004231:Diuresis; D006801:Humans; D006955:Hypernatremia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D008094:Lithium / Q000627:therapeutic use; D008297:Male; D011141:Polyuria / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology
D008094:Lithium