Electrolyte Blood Press.  2012 Dec;10(1):31-34. 10.5049/EBP.2012.10.1.31.

A Case of Syndrome of Inappropriate Scretion of Anti-Diuretic Hormone Associated with Sodium Valproate

• Lee HJ
• Wi JK
• Moon JY
• Jeong KH
• Ihm CG
• Lee SH
• Lee TW

• KMID: 2168392
• DOI: http://doi.org/10.5049/EBP.2012.10.1.31

Abstract

We report a rare case of the concurrent manifestation of central diabetes insipidus (CDI) and type 2 diabetes mellitus (DM). A 56 year-old man was diagnosed as a type 2 DM on the basis of hyperglycemia with polyuria and polydipsia at a local clinic two months ago and started an oral hypoglycemic medication, but resulted in no symptomatic improvement at all. Upon admission to the university hospital, the patient's initial fasting blood sugar level was 140 mg/dL, and he showed polydipsic and polyuric conditions more than 8 L urine/day. Despite the hyperglycemia controlled with metformin and diet, his symptoms persisted. Further investigations including water deprivation test confirmed the coexisting CDI of unknown origin, and the patient's symptoms including an intense thirst were markedly improved by desmopressin nasal spray (10 microg/day). The possibility of a common origin of CDI and type 2 DM is raised in a review of the few relevant adult cases in the literature.

Keyword

Polyuria; Central diabetes insipidus; Type 2 diabetes mellitus; Water deprivation test

MeSH Terms

Adult
Blood Glucose
Deamino Arginine Vasopressin
Diabetes Insipidus, Neurogenic
Diabetes Mellitus, Type 2
Diet
Fasting
Humans
Hyperglycemia
Metformin
Polydipsia
Polyuria
Sodium
Thirst
Valproic Acid
Water Deprivation
Blood Glucose
Deamino Arginine Vasopressin
Metformin
Sodium
Valproic Acid

Figure

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  Fig. 1 Serial change of serum sodium levels during the treatment periods in a patient with hyponatremia after treatment with sodium valproate.

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