An unusual case of central diabetes insipidus & hyperglycemic hyperosmolar state following cardiorespiratory arrest

BMC Research Notes

Abdul Jabbar¹  Ali Asghar¹  Suneel Kumar²  Muhammad Qamar Masood¹ 

[1] Department of Medicine, Section of Endocrinology, Aga Khan University Hospital, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan;Department of Medicine, Endocrinology, Sultan Qaboos University Hospital, Muscat, Oman

关键词: Arrest;    Cardiopulmonary;    State;    Hyperglycemic;    Hyperosmolar;    Insipidus;    Diabetes;    Central;   

Others  :  1141886
DOI  :  10.1186/1756-0500-6-325

 received in 2013-04-25, accepted in 2013-08-12,  发布年份 2013

【 摘 要 】

Background

We are describing an unusual case of severe hyperglycemia and hypernatremia, resistant to treatment.

Case presentation

A thirty year old female with adenocarcinoma of rectum was admitted with increasing lethargy, headache and drowsiness. She deteriorated rapidly and had cardiac arrest, following which she remained comatose. Her initial serum glucose and sodium were normal, but after receiving dexamethasone and mannitol, the serum glucose progressively increased to 54.7 mmol/L and sodium to 175 mmol/L, despite receiving very high dose of intravenous (IV) insulin infusion. She was evaluated for diabetes insipidus because of continued polyuria even after correction of hyperglycemia. Her serum osmolality was 337 mmol/kg, and urine osmolality was 141 mmol/kg which rose to 382 mmol/kg, after receiving 4 mcg of IV Desmopressin.

Conclusion

Our patient developed central diabetes insipidus post cardiac arrest and severe dehydration because of diabetes insipidus. Stress of critical illness, dehydration, dexamethasone and IV dextrose infusion were likely responsible for this degree of severe and resistant to treatment hyperglycemia.

【 授权许可】

   
2013 Masood et al.; licensee BioMed Central Ltd.

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