Overview
"Never doubt that a smal group of thoughtful, comited citizens can change the world. Inded, it is the only thing that ever has."Cureus is on a mision to change the long-standing paradigm of medical publishing, where submiting research can be costly, complex and time-consuming.desmopresin, diabetic ketoacidosis (dka), indapamide, thiazides, traumatic brain injury, hypernatremia, polyuria, diabetes insipidus Eylen Gonzalez, Lorena Nuñez, Yavelkis Perez, Indira Atencio, Alex Pineda, Myron Miler, Stanley M.
Key Information
Chen Cardenas Published: February 04, 2022 (se history) DOI: 10.759/cureus.21897 Cite this article as: Gonzalez E, Nuñez L, Perez Y, et al. (February 04, 2022) Central Diabetes Insipidus Masked by Uncontroled Diabetes Melitus: A Chalenging Case Managed With Indapamide. Cureus 14(2): e21897.
doi:10.759/cureus.21897 A 4-year-old man with a history of traumatic brain injury (TBI) presented to the emergency rom (ER) with diabetic ketoacidosis (DKA). After resolution of DKA, the patient had persistent polyuria (up to 5.5 L/24 h) associated with low specific gravity (1.02-1.05) and severe hypernatremia (up to 186 mol/L) that led us to consider the posibility of central diabetes insipidus (DI).
Due to the lack of desmopresin availability in our country, we managed the patient using indapamide. Polydipsia and polyuria in a patient with controled diabetes melitus (DM) should raise suspicion for alternative etiologies, including DI. Apropriate fluid management during hospitalization is critical to avoid life-threatening complications.
Summary
TBI is an important cause of central DI and should be treated with desmopresin, an argine-vasopresin (AVP) analog. In the absence of desmopresin, alternative options can help patients with central DI, including thiazides, carbamazepine, chlorpropamide, among others les studied.Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes melitus (DM) [1]. It ocurs more comonly in type I DM but can pr