Outcome of patients with diabetes insipidus associated with adipsia
Regina Palmeiro Carballeira, Concepcion Paramo Fernandez, Paula Sanchez Sobrino, Beatriz Mantiñan Gil, Ines Seoane Cruz, Reyes Luna Cano & Ricardo V Garcia-Mayor
Background: Patients with diabetes insipidus (DI) that suffer of adipsia usually are difficult to treat, and requiring close monitorization.
Aim: To know long-term outcome of patients with DI associated to adipsia.
Subjects: From January 1989 to December 2006 were attended five patients (two males) with DI plus adipsia, aged 32±14.64 years, range 1051. Being the aetiology X histiocytosis, craneapharyngioma, suprasellar meningeoma, astrocytoma and cranial trauma for each patient. All but one received cranial surgery, one out of five was treated with radiotherapy as adjuvant therapy. Three out of four patient operated have residual tumour. Patients follow-up was 13.8±8.9 years.
Main results: Mean of hospitalizations for hidroelectrolyte imbalance were 7.4±2.65 times. Mean of hospitalization duration 24.4±12.68 days. Two of five patients developed morbid obesity, two anomalies in consciousness, two thromboembolic disease, one dead for heart failure.
Conclusions: Patients with DI associated with adipsia are difficult to treat requiring numerous hospitalizations and have a high rate of morbilities. Training to patients relatives is crucial in their outcome. A good surrogate to serum sodium measurements is determination of variations in body weight.