Kelley’s textbook of internal medicine PDF fourth Edition Download
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Kelley’s textbook of internal medicine
Let us discuss small topics about Diabetes
Diabetes insipidus (DI) often starts in childhood or early adult life. Men > women.
• Central diabetes insipidus (CDI) is a disorder of the neurohypophyseal system, caused by partial or total deficiency of ADH.
– Results in excessive, dilute urine and increased thirst associated with
– Causes include neoplastic or infiltrative lesions of the hypothalamus or pituitary (60% also have partial or complete loss of anterior pituitary function); in the hypothalamus these lesions can be secondary to craniopharyngioma, etc.; in the pituitary gland, adenoma, leukemia, or sarcoid histocytosis can lead to DI
– Other causes include pituitary or hypothalamic surgery, radiotherapy, severe head injuries, anoxia, hypertension, meningitis
– Idiopathic DI starts in childhood.
– Encephalitis, TB, and syphilis may affect the pituitary as well.
• Nephrogenic diabetes insipidus (NDI) is caused by renal resistance to the action of vasopressin. It can be idiopathic or it can be secondary to hypercalcemia, hypokalemia, sickle cell disease, amyloidosis, myeloma, pyelonephritis, sarcoidosis, or Sjögrensyndrome.
– Causes include drugs (lithium, demeclocycline, colchicine).