Ramírez-Rayón EM, López-Velázquez DF, Adame-Aguilera MA, García-Jiménez FJ, Guadarrama-Quintana JF, Blancas-Cervantes JM

Language: Spanish
References: 12
Page: 16-24
PDF size: 390.75 Kb.

ABSTRACT

Objective: To evaluate the performance of water deprivation test in a series of patients with polyuria-polydipsia syndrome.
Materials and Methods: A descriptive observational study of a series of cases in the internal medicine department of a public general hospital in Acapulco in a period of four years. All patients diagnosed with polyuria-polydipsia syndrome upon admission were included. Secondary causes of polyuria-polydipsia syndrome were excluded.
Results: Nine patients with polyuria-polydipsia syndrome were found; two were excluded because of a diagnosis of polyuric syndrome secondary to a traumatic brain injury. To the remaining 7 patients (2 males and 5 females, in an age range of 18 to 47 years, and an average of 33 years) it was applied water deprivation test. The time of onset of the disease ranged from 1 to 14 months. The volume of fluid intake was between 8 to 12 liters per day. The average duration of the water deprivation test was 5 hours with a range of 5 to 6 hours. During the water deprivation test, two patients presented an increase in urinary osmolarity within a few hours of starting the test, further a decrease in urinary volumes, in these cases diagnosis of polyuria-polydipsia was integrated.
Conclusion: For decades, the differential diagnosis of polyuria-polydipsia syndrome has been based on water deprivation test which continues to be an indispensable tool to establish the diagnosis, as well as offering appropriate treatment for patients.

REFERENCES

1. Christ-Crain M, Rittig S, Verbalis J, Bichet D, et al. Diabetes insipidus. Nat Ret Dis Primers 2019; 5 (1): 54. doi. 10.1038/ s41572-019-0103-2.

2. Catalá M, Gilsanz A, Tortosa F, Zugasti A, et al. Guía clínica del diagnóstico y tratamiento de los trastornos de la neurohipófisis. Endocrinología y Nutrición 2007; 54: 23-33. doi. 10.1016/S1575-0922(07)71402-X.

3. Dundas B, Harris M, Narasimhan M. Psychogenic polydipsia review: Etiology, differential, and treatment. Current Psychiatry Rep 2007; 9 (3): 236-241. doi. 10.1007/s11920- 007-0025-7.

4. Shapiro M. Diabetes insipidus: A review. J Diab Metab 2013; s6 (01). doi. 10.4172/2155-6156.S6-009.

5. Robertson G. Diabetes insipidus: Differential diagnosis and management. Best Pract Res Clin Endocrinol Metab 2016; 30 (2): 205-218.

6. Fost M, Oussaada S, Endert E, Linthorst G, et al. The water deprivation test and a potential role for the arginine vasopressin precursor copeptin to differentiate diabetes insipidus from primary polydipsia. Endocr Connect 2015; 4 (2): 86-91. doi. 10.1530/EC-14-0113.

7. Wong L, Man S. Water deprivation test in children with polyuria. J Pediatr Endocrinol Metab 2012; 25 (9-10): 869- 874. doi. 10.1515/jpem-2012-0092.

8. Timper K, Fenske W, Kühn F, Frech N, et al. Diagnostic accuracy of copeptin in the differential diagnosis of the polyuria-polydipsia syndrome: A prospective multicenter study. J Clin Endocrinol Metab 2015; 100 (6): 2268-2274. doi. 10.1210/jc.2014-4507.

9. Atsariyasing W, Goldman MB. A systematic review of the ability of urine concentration to distinguish antipsychotic- from psychosis-induced hyponatremia. Psychiatry Res 2014; 217: 129-133. doi. 10.1016/j. psychres.2014.03.021.

10. Cheetham T, Ball S. Disorders of water metabolism. In: Sarafoglou K, Hoffmann GF, Roth KS, editors. Pediatric endocrinology and inborn errors of metabolism. USA: McGraw-Hill, 2009: 679-92.

11. Ohlund L, Ott M, Oja S, Bergqvist M, et al. Reasons for lithium discontinuation in men and women with bipolar disorder: a retrospective cohort study. BMC Psychiatry 2018; 18: 37. doi. 10.1186/s12888-018-1622-1.

12. Saifan C, Nasr R, Mehta S, Sharma P, et al. Diabetes insipidus: A challenging diagnosis with new drug therapies. Hindawi Publishing Corporation ISRN Nephrology 2013. https://doi.org/10.5402/2013/797620.