چهارشنبه 17 تیر 1405
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Central diabetes insipidus (CDI) is an uncommon but potentially life-threatening complication in patients with hematologic malignancies. We report a case of a 30-year-old man who presented with upper respiratory symptoms, followed by progressive fatigue, polydipsia, and polyuria. Laboratory evaluation revealed pancytopenia, and bone marrow biopsy confirmed a diagnosis of AML-M2. Despite initial chemotherapy, the patient experienced persistent polyuria and hypernatremia (148–156 mmol/L). Endocrine evaluation revealed urine osmolality of 159 mOsm/kg, serum osmolality of 298 mOsm/kg and a desmopressin challenge confirmed CDI (>50% increase in urine osmolality). MRI demonstrated loss of the posterior pituitary bright spot and deviation of the pituitary stalk. The patient was treated with intranasal desmopressin, with symptomatic improvement. Despite therapy, the leukemia proved refractory, and the patient eventually succumbed to his illness. This case underscores the importance of early recognition of CDI in patients with AML, as timely diagnosis and management can mitigate severe complications.
فهرست منابع
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