Diabetes insipidus is the deficiency or resistance to the hormone vasopressin (antidiuretic hormone), which results in polyuria and polydipsia.
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Epidemiology
Diabetes insipidus occurs in 3 per 100,000 people 2.
Pathology
Diabetes insipidus may be described as 1-3:
central/neurogenic/hypothalamic: vasopressin deficient (more common)
peripheral/nephrogenic: vasopressin resistant
Aetiology
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central diabetes insipidus: reduced secretion of vasopressin
trauma
neurosurgery
malignancy, e.g. craniopharyngioma, germinoma, metastases
autoimmune disease, e.g. lymphocytic hypophysitis
inflammatory disease, e.g. sarcoidosis, Langerhans cell histiocytosis, IgG4-related
infection, e.g. tuberculosis
pregnancy
familial (rare)
idiopathic
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peripheral diabetes insipidus: increased end-organ resistance to vasopressin
congenital renal insensitivity to vasopressin (rare)
long-term lithium use (15% of patients)
metabolic, e.g. hypokalaemia, hypercalcaemia
pregnancy
Treatment and prognosis
Desmopressin can be used to treat central diabetes insipidus 4.
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