Hyperosmolar nonketotic coma precipitated by lithium-induced nephrogenic diabetes insipidus.
case_report · Level V
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- Record sourced from PubMed, PMID 9538487.
- Also identified by PMC identifier 2360797.
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Abstract
A 45-year-old man, with a 10-year history of manic depression treated with lithium, was admitted with hyperosmolar, nonketotic coma. He gave a five-year history of polyuria and polydipsia, during which time urinalysis had been negative for glucose. After recovery from hyperglycaemia, he remained polyuric despite normal blood glucose concentrations; water deprivation testing indicated nephrogenic diabetes insipidus, likely to be lithium-induced. We hypothesize that when this man developed type 2 diabetes, chronic polyuria due to nephrogenic diabetes insipidus was sufficient to precipitate hyperosmolar dehydration.
Medical subject headings
- Antimanic Agents
- Diabetes Insipidus, Nephrogenic
- Hyperglycemic Hyperosmolar Nonketotic Coma
- Lithium Carbonate