Diabetes insipidus

This is caused by disease or damage affecting the hypothalamic-pos-terior pituitary axis. Common causes are pituitary tumours, craniopharyngiomas, basal skull fracture and infection, or it may occur as a sequel to pituitary surgery. In 10% of cases, diabetes insipidus is renal in origin.

Dehydration with hypernatraemia follows excretion of large volumes of dilute urine. Patients require fluid replacement and treatment with vasopressin (DDAVP; desmopressin 2-4 pg i.m. daily or 1 pg i.v. in the acute situation).

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