Nephrogenic diabetes insipidus: an unusual presentation of recurrent rectal cancer
Article Abstract:
Under normal circumstances, the body regulates the retention of the proper amount of water by the secretion of the hormone vasopressin. This substance, released by the posterior pituitary gland, triggers the retention of water which would otherwise be lost from the kidneys. Diabetes insipidus is a condition in which copious amounts of water are lost from the body in the form of excessive highly dilute urine. This condition is not common, but may result from a number of conditions, including the growth of a metastatic cancer in the pituitary or the overlying hypothalamus. A case has now been seen, however, in which diabetes insipidus resulted from the effects of a rectal tumor directly influencing normal kidney function. The 43-year-old male patient sought medical attention because he was urinating too much and had to drink too much water (polyuria and polydipsia). The patient urinated every 30 minutes and drank six liters of water a day. A medical history revealed that eight months prior the patient had undergone surgery to remove a rectal tumor. The patient's diabetes insipidus was treated with desmopressin acetate, to no avail. The failure of desmopressin to resolve the symptoms suggested that the problem lay not in the inadequate secretion of vasopressin, as is usually the case, but rather in the kidneys themselves. An ultrasound image revealed indications of hydronephrosis, a condition in which the kidneys are soggy with excess fluid. Further examination revealed recurrence of the rectal tumor which had invaded the urinary bladder and was partially obstructing the flow of urine. The increase in pressure resulting from this obstruction apparently caused the hydronephrosis and the resulting abnormal kidney function. The patient deteriorated rapidly. Permission for an autopsy was not granted in this case. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Cancer
Subject: Health
ISSN: 0008-543X
Year: 1991
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Treatment of cytomegalovirus retinitis in patients with AIDS
Article Abstract:
A combination of drugs that target the eye as well as the rest of the body may prove to be the most effective treatment for patients with cytomegalovirus (CMV) retinitis. CMV retinitis is one of the most common CMV infections in patients with the AIDS. Currently approved therapies involve a highly concentrated first treatment to control the infection followed by low level follow-up treatments to maintain control of the infection. Most therapies given intravenously do not achieve high enough levels within the eye and those given locally do not control the infection throughout the body.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1996
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- Abstracts: Nephrogenic diabetes insipidus and intracerebral calcification. Continuous vasopressin replacement in diabetes insipidus
- Abstracts: Nephrogenic diabetes insipidus associated with foscarnet treatment of cytomegalovirus retinitis
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