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Central diabetes insipidus, recently renamed arginine vasopressin deficiency (AVP-D), [1] is a form of diabetes insipidus that is due to a lack of vasopressin (ADH) production in the brain. Vasopressin acts to increase the volume of blood (intravascularly), and decrease the volume of urine produced.
A fluid or water deprivation test is a medical test [1] which can be used to determine whether the patient has diabetes insipidus as opposed to other causes of polydipsia (a condition of excessive thirst that causes an excessive intake of water). The patient is required, for a prolonged period, to forgo intake of water completely, to determine ...
The causes of SIADH are commonly grouped into categories including: central nervous system diseases that directly stimulate the hypothalamus to release ADH, various cancers that synthesize and secrete ectopic ADH, various lung diseases, numerous drugs (carbamazepine, cyclophosphamide, SSRIs) that may stimulate the release of ADH, vasopressin ...
The number of new cases of diabetes insipidus each year is 3 in 100,000. [4] Central DI usually starts between the ages of 10 and 20 and occurs in males and females equally. [2] Nephrogenic DI can begin at any age. [3] The term "diabetes" is derived from the Greek word meaning siphon. [6]
The anterior pituitary is more commonly affected in Sheehan's syndrome because of the structure of the portal venous system. Posterior pituitary involvement leading to central diabetes insipidus is much rarer, and typically reflects more extensive damage to the organ and more severe disease. [13]
This means that psychogenic polydipsia may lead to test results (e.g. in a water restriction test) consistent with diabetes insipidus or SIADH, leading to misdiagnosis. [14] Dry mouth is often a side effect of medications used in the treatment of some mental disorders, rather than being caused by the underlying condition. [15]
The main clinical difference is that of total fluid status of the patient: CSWS leads to a relative or overt low blood volume [3] whereas SIADH is consistent with a normal or high blood volume (due to water reabsorption via the V2 receptor). [1] If blood-sodium levels increase when fluids are restricted, SIADH is more likely. [13]
Antidiuretics reduce urine volume, particularly in diabetes insipidus (DI), which is one of their main indications. The antidiuretic hormone class includes vasopressin (ADH), argipressin, desmopressin, lypressin, ornipressin, oxytocin, and terlipressin. Miscellaneous others include chlorpropamide and carbamazepine.