1) however, this was considered a nonspecific finding. An magnetic resonance imaging (MRI) revealed a decrease of hypophysis intensity ( Fig. A complete physical examination was normal, as were a PA chest radiograph and an electrocardiogram (ECG). The patient was not pregnant and during her last pregnancy, which was 10 years ago, she did not experience peripartum complications. The patient had no history of neurosurgery or trauma and no evidence of systemic illness such as weight loss and fever. The patient did not receive any medications except for insulin. The patient's family history was unremarkable. In view of these results, a diagnosis of central diabetes insipidus was made. After the administration of desmopressin, urine specific gravity increased to 1.019 (in a 24-hour urine collection) and urine osmolality increased to 488 mmol/kg. No significant increase occurred, either in urine specific gravity or urine osmolality. A water deprivation test was then performed. These findings were consistent with diabetes insipidus. A urine and plasma osmolality was subsequently performed, which were 138 and 285 mmol/kg, respectively. Therefore, we suspected that diabetes insipidus might be the underlying cause, owing to the presence of a persistently low urine specific gravity. 3, 4 On repeated urine analysis, a 24-hour urine collection revealed a urine specific gravity of 1.008. A spot urine analysis revealed a urine specific gravity of 1.008 and a 24-hour urine collection revealed a urine specific gravity of 1.007. Blood sampling for routine laboratory values were: hemoglobin (Hb), 8.8 mmol/L platelet count (Plt), 230,000 per mm 3 white blood cells (WBC), 6,320 per mm 3 creatinine, 98 μmol/L urea nitrogen, 5.2 mmol/L uric acid, 351 μmol/L aspartate transaminase (AST), 0.35 μkat/L alanine transaminase ALT, 0.47 μkat/L Na, 132 mmol/L K, 4.5 mmol/L glucose, 19.5 mmol/L (351 mg/dL) Ca, 2.3 mmol/L albumin, 43 g/L erythrocyte sedimentation rate, 19 mm/h C-reactive protein 2.1 mg/L and an HbA 1C of 0.0107 Hb fraction. The patient drank an average of 5 L/d and her urine output was almost the same. She had a 10-year history of type 2 diabetes mellitus, with poor glycemic control that required insulin. A 46-year-old woman was referred to our hospital because of worsening polyuria and polydipsia of 2 months duration.
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