Masked central diabetes insipidus after cortisol replacement:3 case reports and review of literature

Tang Ziwei; Long Jian; Liu Chun

doi:10.13406/j.cnki.cyxb.001297

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Masked central diabetes insipidus after cortisol replacement:3 case reports and review of literature

更新时间：2024-01-17

- Masked central diabetes insipidus after cortisol replacement:3 case reports and review of literature
- Journal of Chongqing Medical University Vol. 42, Issue 5, Pages: 596-600(2017)
- 作者机构：
  
  重庆医科大学附属第一医院内分泌内科
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.001297
  CLC： R584.3
- Published：2017，
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Tang Ziwei, Long Jian, Liu Chun. Masked central diabetes insipidus after cortisol replacement:3 case reports and review of literature. [J]. Journal of Chongqing Medical University 42(5):596-600(2017)
DOI：

Tang Ziwei, Long Jian, Liu Chun. Masked central diabetes insipidus after cortisol replacement:3 case reports and review of literature. [J]. Journal of Chongqing Medical University 42(5):596-600(2017) DOI： 10.13406/j.cnki.cyxb.001297.

摘要

目的:提高临床医师对隐性中枢性尿崩症的认识。方法:对3例腺垂体功能减退使用糖皮质激素后出现尿崩症的患者进行病例分析

同时查询中国知网、维普以及Pub Med等中英文数据库

找到相关病例

总结其临床特点。结果:3例患者均存在HPA轴、甲状腺轴以及性腺轴功能减退

给予糖皮质激素替代后

均出现尿量、血钠、血氯、血渗透压明显升高

尿比密明显下降

其中2例完成禁水加压素试验

尿渗透压较推药前上升超过9%

另1例给予醋酸去氨加压素后尿量明显减少。同时

通过文献检索发现了9篇相关病例报道

并就各自临床特点进行了汇总。结论:隐性中枢性尿崩症在临床上较为罕见

典型症状因为糖皮质激素缺乏而被隐藏

当腺垂体功能减退患者在给予糖皮质激素治疗后若出现明显多尿以及低比重尿时

应考虑合并中枢性尿崩症。

Abstract

Objective:To enhance the awareness of masked central diabetes insipidus by introducing three cases and reviewing literature. Methods:The common characteristics of these cases were analyzed

and literature from CNKI

VIP as well as Pub Med database was searched and 9 relative case reports were found out. Results:Our cases all presented with classic hypopituitarism symptoms and increased urine volume

serum sodium

serum chloride as well as serum osmotic pressure after cortisol replacement. They also presented with decreased urine gravity. Two of them finished water deprivation and AVP injection test with a over 9 % increase in urine osmotic pressure as a result. The other started on desmopressin and presented with significant urine volume reduction. Conclusion:Masked central diabetes insipidus is not frequent. However

when hypopituitarism patients encountered polyuria with decreased urine osmotic pressure after cortisol replacement

it should be considered the possibility of coexisting diabetes insipidus.

关键词

腺垂体功能减退糖皮质激素中枢性尿崩症抗利尿激素

Keywords

hypopituitarismcortisolcentral diabetes insipidusantidiuretic hormone

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Case analysis of 4 patients with CDI combined with HHS

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Related Institution

Department of Endocrinology,the People’s Hospital of Shapingba District of Chongqing

Department of Endocrinology,The First Affiliated Hospital of Chongqing Medical University

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