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H Lasolle1, F Borson-Chazot1

  • 1Fédération d'Endocrinologie, Hospices Civils de Lyon, Groupement Hospitalier Est, 59 Boulevard Pinel, 69677 Bron, France; Université Lyon 1, 43 Boulevard du 11 novembre 1918, 69100 Villeurbanne, France.

Annales D'Endocrinologie
|June 25, 2017
PubMed
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Diabetes insipidus (DI) is a condition causing excessive thirst and urination. Diagnosing its cause, whether central or renal, is key for effective management, with copeptin aiding differentiation.

Area of Science:

  • Endocrinology
  • Nephrology
  • Neuroscience

Background:

  • Diabetes insipidus (DI) is characterized by hypotonic polyuria and polydipsia.
  • It results from arginine vasopressin (AVP) deficiency or resistance.
  • Accurate diagnosis is crucial for appropriate patient management.

Purpose of the Study:

  • To highlight the diagnostic challenges in differentiating central DI, nephrogenic DI, and primary polydipsia.
  • To emphasize the utility of copeptin in the diagnostic workup of DI.
  • To review the causes and management of central DI.

Main Methods:

  • Review of medical history and response to treatment.
  • Magnetic resonance imaging (MRI) for identifying structural causes.
  • Basal and osmotically stimulated copeptin level measurements.
Keywords:
Arginine vasopressinArginine vasopressineCopeptinCopeptineDiabetes insipidusDiabète insipidePolydipsiaPolydipsie

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  • Genetic analysis for suspected hereditary forms.

    • Main Results:

    • Water deprivation tests have limited reliability.
    • Copeptin levels can help distinguish between nephrogenic DI, central DI, and primary polydipsia.
    • Central DI is common post-pituitary surgery or head trauma, often transient.
    • Genetic mutations in the AVP gene are implicated in familial cases.
    • MRI detects tumors, inflammatory diseases, and pituitary stalk thickening.

    Conclusions:

    • Copeptin offers a valuable tool for diagnosing the specific type of diabetes insipidus.
    • Early diagnosis and appropriate management, often with desmopressin, are essential for central DI.
    • Comprehensive evaluation is necessary to rule out other causes before diagnosing idiopathic DI.