Endocrine Abstracts

72 year old female patient admitted with constipation and vomiting. Whilst admitted to hospital, the patient was found to have significant hypernatraemia with a sodium level of 174 with reduced GCS. The patient had been under endocrine service and was being investigated for suspected cranial diabetes insipidus, having missed two doses of desmopressin due to being unwell she developed this significant hypernatraemia. She was treated with a complex fluid regime and desmopressin which gradually decreased her sodium to within normal range over 48 hours. With treatment, her GCS significantly improved and she returned back to her baseline. The patient had a background of central nervous system (CNS) vasculitis which was likely the cause of the cranial diabetes insipidus. CNS vasculitis is a rare disorder with an estimated annual incidence rate of 2.4 cases per 1 million person-years (Goads, Chauhan & Bollu, 2023). Immune system activation results in inflammation and damage to the blood vessels and brain structure, this damage and insult to the brain likely led to the pituitary gland being compromised. The patient experienced a life-threatening emergency as a result of this insult which conclusively proved that she did indeed have cranial diabetes insipidus.