J Korean Soc Endocrinol.  2001 Apr;16(2):190-198.

Clinical Course of Idiopathic Central Diabetes Insipidus in Adults

• Jeon HJ
• Park SH
• Kwon SH
• Lee SH
• Park KS

Abstract

BACKGROUND
Idiopathic Central Diabetes Insipidus in children or adolescents requires a frequent follow-up regimen using serial brain MRI and CSF examinations especially if an isolated pituitary stalk thickening or loss of a hyperintense signal in the posterior pituitary lobe is observed. Although a detailed description has not been made in adults who had Idiopathic Central Diabetes Insipidus, the clinical course of a Central Diabetes Insipidus in children or in adolescents can not be applied to adults because a follow-up study is so invasive and expensive. In this report, we evaluated the clinical course of Idiopathic Central Diabetes Insipidus in adults.
METHODS
The diagnosis of Idiopathic Central Diabetes Insipidus was based on the presenting clinical symptoms, the water deprivation test, biochemical studies and a brain MRI. We measured the urine specific gravity, urine and plasma osmolarity, electrolytes, and daily urine amount and we also performed an anterior pituitary evaluation. Patients had contrast-enhanced MRI and biochemical studies every 4 to 12 months.
RESULTS
The patients included 8 females and 4 males. Their ages ranged from 20 to 76 years and their mean age was 45+/-17 years. Tumor markers in the CSF were not detected any of the patients. An anterior pituitary evaluation showed that four patients had hyperprolactinemia, and five patients had impaired secretory responses of Growth Hormone to an insulin induced hypoglycemia. Nine of the 12 patients had thickening of the pituitary stalk, seven had lacked the hyperintense signal of a normal neurohypophysis. The abnormalities of MRI disappeared in 3 patients by the 4th, 27th and 36th month follow up periods, respectively. The follow up duration was between 8 months and 11 years 3 months and the mean follow up duration period was 50.6+/-45.5 months. Clinical symptoms were corrected by DDAVP administration. Other symptoms were absent.
CONCLUSION
In our study, of Idiopathic Central Diabetes Insipidus in adults there were no observed germinomas or other disease that were observed. Therefore this disorder may have a benign course.

MeSH Terms

Adolescent
Adult*
Brain
Child
Deamino Arginine Vasopressin
Diabetes Insipidus, Neurogenic*
Diagnosis
Electrolytes
Female
Follow-Up Studies
Germinoma
Growth Hormone
Humans
Hyperprolactinemia
Hypoglycemia
Insulin
Magnetic Resonance Imaging
Male
Osmolar Concentration
Pituitary Gland
Pituitary Gland, Posterior
Plasma
Specific Gravity
Biomarkers, Tumor
Water Deprivation
Deamino Arginine Vasopressin
Electrolytes
Growth Hormone
Insulin