A 19-year-old man with Marfan syndrome presents with acute-onset polyuria (10 L/day) and polydipsia. Vital signs: BP 118/76, HR 88, RR 16, temp 37°C, SpO2 98%. Labs show serum osmolality 310 mOsm/kg, serum glucose 95 mg/dL, and urine osmolality 150 mOsm/kg. No recent head trauma or infection history. Desmopressin administration increases urine osmolality to 600 mOsm/kg. Which diagnosis best explains these findings?
- A)Nephrogenic diabetes insipidus
- B)Psychogenic polydipsia
- C)Primary hyperaldosteronism
- D)Uncontrolled diabetes mellitus
- E)Central diabetes insipidusGABARITO
Explicação
Central diabetes insipidus results from ADH deficiency due to pituitary/hypothalamic pathology. The response to desmopressin (urine osmolality increases from 150 to 600 mOsm/kg) confirms ADH-responsive diabetes insipidus. Marfan syndrome patients are at risk f... Ver explicação completa e trilha adaptativa →