Central diabetes insipidus
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Clinic
- Also called neurogenic diabetes insipidus, is a type of diabetes insipidus due to a lack of vasopressin (ADH) production in the brain.
- Vasopressin acts to increase the volume of blood (intravascularly), and decrease the volume of urine produced. Therefore, a lack of it causes increased urine production and volume depletion.
- It is also known as neurohypophyseal diabetes insipidus, referring to the posterior pituitary (neurohypophysis), which is supplied by the hypothalamus in the brain. This condition has only polyuria in common with diabetes. Although not mutually exclusive, with most typical cases, the name diabetes insipidus is a misleading misnomer. A better name might be "hypothalamic-neurohypophyseal ADH deficiency".
Signs and symptoms
Increased thirst, polyuria and dehydration with metabolic encephalopathy.
Causes
- At least 25% of cases neurogenic diabetes insipidus has unknown cause.
- Known causes are
- Benign suprasellar tumors (20% of cases)
- Infections (encephalitis, tuberculosis, etc.)
- Trauma (17% of cases) or neurosurgery (9% of cases)
- Non-infectious granuloma (sarcoidosis, Langerhans cell histiocytosis etc.)
- Leukaemia
- Autoimmune - associated with thyroiditis
- Other rare causes which include hemochromatosis and histiocytosis.