Diabetes insipidus causes
|
Diabetes insipidus Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Diabetes insipidus causes On the Web |
|
American Roentgen Ray Society Images of Diabetes insipidus causes |
|
Risk calculators and risk factors for Diabetes insipidus causes |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Causes
Central DI
CDI is caused by the destruction or degeneration of neurons originating in the supraoptic and paraventricular nuclei. Central DI, results from damage to the pituitary gland, which disrupts the normal storage and release of ADH. The most common cause of central diabetes insipidus (CDI), accounting for the vast majority of cases, are idiopathic diabetes insipidus (DI)[1][2]. Others include[2];
- Familial and congenital disease
- Neurosurgery or trauma[7][8]
- Cancer[1]
- Hypoxic encephalopathy
- Infiltrative disorders[9][10]
- Langerhans cell histiocytosis (LCH)
- eosinophilic granuloma
- Post-supraventricular tachycardia[11]
- Anorexia nervosa[12]
Nephrogenic DI
Nephrogenic DI results when the kidneys are unable to respond to ADH. The kidneys’ ability to respond to ADH can be impaired by;
- Drugs
- Chronic disorders including
- polycystic kidney disease
- sickle cell disease
- kidney failure
- Partial blockage of the ureters
- Inherited genetic disorders
- Idiopathic causes
Dipsogenic DI
Dipsogenic DI is caused by a defect in or damage to the thirst mechanism, which is located in the hypothalamus. This defect results in an abnormal increase in thirst and fluid intake that suppresses ADH secretion and increases urine output. Desmopressin or other drugs should not be used to treat dipsogenic DI because they may decrease urine output but not thirst and fluid intake. This fluid overload can lead to water intoxication, a condition that lowers the concentration of sodium in the blood and can seriously damage the brain. Scientists have not yet found an effective treatment for dipsogenic DI.
Gestational DI
Gestational DI occurs only during pregnancy and results when an enzyme made by the placenta destroys ADH in the mother. The placenta is the system of blood vessels and other tissue that develops with the fetus. The placenta allows exchange of nutrients and waste products between mother and fetus.Most cases of gestational DI can be treated with desmopressin. In rare cases, however, an abnormality in the thirst mechanism causes gestational DI, and desmopressin should not be used.
Common causes
- Idiopathic: 30% to 50% of all cases
- Head injury, especially basal skull fractures
- Hypothalamic tumors, Pineal tumors
- Metastases (especially lung and breast)
Causes by Organ System
| Cardiovascular | Hypovolemic shock |
| Chemical / poisoning | No underlying causes |
| Dermatologic | No underlying causes |
| Drug Side Effect | Amphotericin B, Demeclocycline, Lithium , Radiation - for CNS and nasopharyngeal malignancies , Pituitary radiation , Netilmicin , Kanamycin, Carbamazepine , Amikacin |
| Ear Nose Throat | No underlying causes |
| Endocrine | Ischemia of the pitutary gland , Sheehan syndrome , Pituitary tumour , Panhypopituitarism , lymphocytic hypophysitis , Familial hypopituitarism , congenital nephrogenic , Congenital hypopituitarism , Apoplexy , pituitary cysts |
| Environmental | No underlying causes |
| Gastroenterologic | No underlying causes |
| Genetic | Inherited genetic kidney disorders , Genetic diseases - pit-1 mutation |
| Hematologic | Sickle cell disease , Langerhans cell histiocytosis |
| Iatrogenic | Neurosurgery , Pituitary surgery |
| Infectious Disease | Tuberculous meningitis , Meningoencephalitis , Infections |
| Musculoskeletal / Ortho | No underlying causes |
| Neurologic | Dipsogenic diabetes insipidus , Ischemic encephalopathy , Subarachnoid hemorrhage , Mass lesions hypothalamus , Ischemic stroke , Intracranial space-occupying lesion , Intracranial bleeding , Hypoxic encephalopathy , Hypothalamic radiation , Brain aneurysm |
| Nutritional / Metabolic | Hypercalcemia , hemochromatosis , Anorexia nervosa |
| Obstetric/Gynecologic | Gestational diabetes insipidus |
| Oncologic | Pituitary Cancer , pituitary adenomas , malignant tumors infilterating hypothalamus from lung and breast , Histiocytosis , Craniopharyngioma |
| Opthalmologic | No underlying causes |
| Overdose / Toxicity | No underlying causes |
| Psychiatric | No underlying causes |
| Pulmonary | No underlying causes |
| Renal / Electrolyte | Polycystic kidney disease, Renal failure , Interstitial nephritis , Hypokalaemia , Hypercalcaemia |
| Rheum / Immune / Allergy | Sarcoidosis , Autoimmune Hypophysitis , Autoimmune Diabetes Insipidus |
| Sexual | No underlying causes |
| Trauma | Head injury , Trauma - fracture of skull base |
| Urologic | Partial blockage of the ureters |
| Dental | No underlying causes |
| Miscellaneous | Dehydration , Wolfram syndrome , Sicca syndrome , Septo-optic dysplasia , Infiltrative lesions , Idiopathic , Hand-Schuller-Christian Syndrome , Familial CDI , Erdheim-Chester disease , DIDMOAD syndrome , Anophthalmia -- hypyothalamo-pituitary insufficiency , Anophthalmia -- hypothalamo-pituitary insufficiency , Amyloidosis |
Causes in Alphabetical Order
|
|
|
References
- ↑ 1.0 1.1 Kimmel DW, O'Neill BP (1983). "Systemic cancer presenting as diabetes insipidus. Clinical and radiographic features of 11 patients with a review of metastatic-induced diabetes insipidus". Cancer. 52 (12): 2355–8. PMID 6640507.
- ↑ 2.0 2.1 Maghnie M, Cosi G, Genovese E, Manca-Bitti ML, Cohen A, Zecca S; et al. (2000). "Central diabetes insipidus in children and young adults". N Engl J Med. 343 (14): 998–1007. doi:10.1056/NEJM200010053431403. PMID 11018166.
- ↑ Burbach JP, Luckman SM, Murphy D, Gainer H (2001). "Gene regulation in the magnocellular hypothalamo-neurohypophysial system". Physiol Rev. 81 (3): 1197–267. PMID 11427695.
- ↑ Bischoff AN, Reiersen AM, Buttlaire A, Al-Lozi A, Doty T, Marshall BA; et al. (2015). "Selective cognitive and psychiatric manifestations in Wolfram Syndrome". Orphanet J Rare Dis. 10: 66. doi:10.1186/s13023-015-0282-1. PMC 4450481. PMID 26025012.
- ↑ Yagi H, Nagashima K, Miyake H, Tamai S, Onigata K, Yutani S; et al. (1994). "Familial congenital hypopituitarism with central diabetes insipidus". J Clin Endocrinol Metab. 78 (4): 884–9. doi:10.1210/jcem.78.4.8157716. PMID 8157716.
- ↑ Hoyt WF, Kaplan SL, Grumbach MM, Glaser JS (1970). "Septo-optic dysplasia and pituitary dwarfism". Lancet. 1 (7652): 893–4. PMID 4191531.
- ↑ Seckl J, Dunger D (1989). "Postoperative diabetes insipidus". BMJ. 298 (6665): 2–3. PMC 1835326. PMID 2492841.
- ↑ Nemergut EC, Zuo Z, Jane JA, Laws ER (2005). "Predictors of diabetes insipidus after transsphenoidal surgery: a review of 881 patients". J Neurosurg. 103 (3): 448–54. doi:10.3171/jns.2005.103.3.0448. PMID 16235676.
- ↑ Grois N, Fahrner B, Arceci RJ, Henter JI, McClain K, Lassmann H; et al. (2010). "Central nervous system disease in Langerhans cell histiocytosis". J Pediatr. 156 (6): 873–81, 881.e1. doi:10.1016/j.jpeds.2010.03.001. PMID 20434166.
- ↑ Dunger DB, Broadbent V, Yeoman E, Seckl JR, Lightman SL, Grant DB; et al. (1989). "The frequency and natural history of diabetes insipidus in children with Langerhans-cell histiocytosis". N Engl J Med. 321 (17): 1157–62. doi:10.1056/NEJM198910263211704. PMID 2797079.
- ↑ Canepa-Anson R, Williams M, Marshall J, Mitsuoka T, Lightman S, Sutton R (1984). "Mechanism of polyuria and natriuresis in atrioventricular nodal tachycardia". Br Med J (Clin Res Ed). 289 (6449): 866–8. PMC 1443391. PMID 6434116.
- ↑ Gold PW, Kaye W, Robertson GL, Ebert M (1983). "Abnormalities in plasma and cerebrospinal-fluid arginine vasopressin in patients with anorexia nervosa". N Engl J Med. 308 (19): 1117–23. doi:10.1056/NEJM198305123081902. PMID 6835335.