Transient central diabetes insipidus in the setting of underlying chronic nephrogenic diabetes insipidus associated with lithium use.
Nephrogenic diabetes insipidus (NDI) is a well-documented complication of lithium use. The association of central diabetes insipidus (CDI) with lithium use is rare. We report a patient receiving chronic lithium therapy who presented with a transient CDI occurring in the setting of underlying chronic NDI. To the best of our knowledge, this is the first case of lithium-associated CDI and NDI presenting concurrently. Potential mechanisms regarding the pathophysiology of lithium-associated CDI are discussed. This case emphasizes the importance of the evaluation of lithium-associated polyuria with a direct measurement of plasma vasopressin, interpreted with simultaneous plasma and urine osmolality to secure the correct diagnosis and ensure appropriate therapeutic management.
Posner
L
L
Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Mokrzycki
M H
MH
D000368:Aged; D018692:Antimanic Agents / Q000009:adverse effects*; D001714:Bipolar Disorder / Q000188:drug therapy; D002908:Chronic Disease; D003919:Diabetes Insipidus / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis; D018500:Diabetes Insipidus, Nephrogenic / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D016651:Lithium Carbonate / Q000009:adverse effects*
D018692:Antimanic Agents; D016651:Lithium Carbonate