Myelodysplastic syndrome with central diabetes insipidus manifesting hypodipsic hypernatremia and dehydration
Autor: | Kinuko Mitani, Yuui Kishimoto, Fumihiko Nakamura, Yukihiro Arai, Tomoyuki Handa |
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Rok vydání: | 2004 |
Předmět: |
medicine.medical_specialty
medicine.medical_treatment Gastroenterology Thirst Pituitary Gland Posterior Polyuria Internal medicine Humans Medicine Radionuclide Imaging Chemotherapy Leukemic Infiltration Hypernatremia Dehydration business.industry Osmolar Concentration Hematology Middle Aged medicine.disease Magnetic Resonance Imaging Diabetes Insipidus Neurogenic Endocrinology Myelodysplastic Syndromes Diabetes insipidus Cytarabine Female medicine.symptom business Polydipsia medicine.drug |
Zdroj: | American Journal of Hematology. 75:213-216 |
ISSN: | 1096-8652 0361-8609 |
Popis: | Central diabetes insipidus (DI) is a rare but recognized complication of myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) that is caused by leukemic infiltration to the hypothalamo-neurohypophyseal system. In rare patients in whom a wide region of the hypothalamus is involved, central DI results in hypodipsic hypernatremia and dehydration. Typical DI symptoms such as polydipsia, polyuria, and marked thirst are concealed in these cases, because the hypothalamic "thirst center" cannot send thirst stimuli to the cerebral cortex. Herein we describe a patient with MDS developing into AML, who presented with hypodipsic hypernatremia and dehydration. A diagnosis of central DI was made on the ground of a low level of serum anti-diuretic hormone (ADH) despite high serum osmolality. A magnetic resonance imaging study revealed attenuation of a physiological "bright spot" of the neurohypophysis. An induction course chemotherapy including regular-dose cytarabine and daunorubicin produced a rapid improvement of hypernatremia. The bone marrow aspirate after two courses of chemotherapy showed complete remission. At that point, ADH release and the "bright spot" were recovered. In order to correctly diagnose central DI in association with hematological malignancies, we should not overlook this atypical type of DI. |
Databáze: | OpenAIRE |
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