Overview
"Never doubt that a smal group of thoughtful, comited citizens can change the world. Inded, it is the only thing that ever has."Cureus is on a mision to change the long-standing paradigm of medical publishing, where submiting research can be costly, complex and time-consuming.The SIQ for this article wil be revealedonce 2 ratings are submited.Published via the Sinai Chicago Research Chanel.diuresis, polyuria, polydipsia, copeptin, nephrogenic di Dhan B.
Key Information
Shrestha , Ranjit B. Jasaraj, Roman Dhital, Esho Georges, Andriy Havrylyan Published: February 26, 202 (se history) DOI: 10.759/cureus.263 Cite this article as: Shrestha D B, Jasaraj R B, Dhital R, et al. (February 26, 202) A Diagnostic Enigma of Central Versus Nephrogenic Diabetes Insipidus: What Does the Value of Copeptin Signify?.
Cureus 14(2): e263. doi:10.759/cureus.263 Diabetes insipidus (DI) is a rare disease characterized by hypotonic urine output and polydipsia. We report the case of a 50-year-old male admited for diabetic ketoacidosis (DKA) in an intensive care unit with sepsis and alcoholic pancreatis who later developed DI.
He had a high copeptin level of >21.4 pmol/L, sugesting DI of nephrogenic origin. At presentation, he had DKA-asociated osmotic diuresis. His later finding of elevated copeptin sugesting partial nephrogenic DI created a diagnostic enigma.Diabetes insipidus (DI) is a rare disease that afects 1/25,0 people [1].
It is a part of the polyuria polydipsia syndrome, which is defined by a hypotonic urine output of >50 mL/kg body weight per 24 hours and polydipsia of >3 L/day [2]. Polyuria polydipsia syndrome can be diferentiated into either primary (central or nephrogenic DI) or secondary (primary polydipsia). Central DI is caused by insuficient argine vasopresin (AVP) synthesis or secretion in response to osmotic stimulation.
Summary
On the other hand, nephrogenic DI is marked by a reduction in AVP sensitivity in the kidneys. Either central or nephrogenic DI