A 29-year-old woman develops polydipsia and polyuria 2 days after transsphenoidal pituitary adenoma resection. Vital signs show HR 98/min, BP 132/84 mmHg, RR 16/min. Serum sodium is 151 mEq/L with normal potassium. Urine osmolality is 180 mOsm/kg, and 24-hour urine output exceeds 3 liters. She denies prior diabetes mellitus. Following desmopressin administration, urine osmolality increases to 580 mOsm/kg. Which diagnosis best explains these findings?
- A)Type 4 renal tubular acidosis
- B)Nephrogenic diabetes insipidus
- C)Central diabetes insipidusGABARITO
- D)Primary polydipsia
- E)SIADH
Explicação
Central diabetes insipidus is correct. Pituitary surgery can reduce ADH secretion, causing inability to concentrate urine and resulting in hypernatremia with polyuria. A robust rise in urine osmolality after desmopressin confirms that the kidneys can respond t... Ver explicação completa e trilha adaptativa →