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Acute leukemia relapse presenting as central diabetes insipidus
P Ra'anani1, O Shpilberg, M Berezin
1Institute of Hematology, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Background:
Diabetes insipidus due to leukemic involvement of the central nervous system has been described previously in several patients. Although the timing of the diabetes insipidus onset in relation to the leukemia is variable, it has not been described previously as the first manifestation of leukemia relapse.
Methods:
Two cases of leukemia relapse presenting as central diabetes insipidus are described and the literature is reviewed.
Results:
Clinical data of 29 of the 39 reported cases were available. The median age was 46 years, with no gender predominance. Seventy-three percent had acute nonlymphocytic leukemia, and deletion of chromosome 7 or monosomy 7 was the predominant cytogenetic abnormality. No temporal relation between the onset of diabetes insipidus and the leukemia was found. In none of the previously reported cases was diabetes insipidus the first manifestation of the leukemia recurrence.
Conclusions:
The temporal relationship between diabetes insipidus and leukemia is inconsistent. The former may precede, follow, or present concomitantly with the latter. Two cases of diabetes insipidus as the presenting sign of leukemia relapse are reported.