Hyperosmolar nonketotic coma precipitated by lithium-induced nephrogenic diabetes insipidus. Issue 867 (January 1998)

• Record Type: Journal Article
• Authors: Azam, H.; Newton, R. W.; Morris, A. D.; Thompson, C. J.
• Is Part Of: Postgraduate medical journal. Volume 74:Issue 867(1998)
• Page Start: 39
• Page End: 41
• Publication Date: 1998-01
• Subjects: Medicine -- Periodicals; 610
• DOI: 10.1136/pgmj.74.867.39
• Languages: English
• ISSNs: 0032-5473

Abstract

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.