Diabetes insipidus syndrome is also referred to by doctors as diabetes insipidus.
The reason for this name is that the decrease and lack of production and secretion of anti-diuretic hormone, causes the production of a large volume of very dilute urine that is so dilute that it seems to have no taste!
In the following you will learn more about Antipyretic Hormone Disorder Syndrome, or SIADH for short.
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What is an anti-diuretic hormone or ADH?
This hormone is produced in the pituitary gland, which is located inside our brain and is secreted into the blood. Doctors say only cells in the dorsal pituitary gland are responsible for producing and secreting this hormone. So it is the disorders and problems of the dorsal part of the pituitary gland that can cause SIADH. The function of ADH is to prevent your kidneys from producing very thin urine and not to allow your body to lose too much water, and it protects your body from becoming dehydrated.
So too much secretion of this hormone can put your body in certain conditions, which we will discuss below.
Symptoms of diabetes insipidus or ADH
Excessive ADH secretion causes that:
- Frequent urination is very dilute:
Frequent urination disturbs the sufferer
The volume of urine during twenty-four hours will be between three and twenty liters
In a type of SIADH called the central type, which occurs following a disorder of the pituitary gland, the volume of urine in twenty-four hours can even reach 30 liters.
- There is a great feeling of thirst in the affected person:
In other words, this disorder is sometimes called polydipsia and polyuria, which means that the sufferer urinates a lot and is very thirsty to drink water.
In diabetes insipidus or ADH, the body is unable to control the body’s water balance, the kidneys lose too much water, and if the person does not increase their water intake and drink, their body will become severely dehydrated. This complication is especially dangerous in people who cannot express their thirst, such as people with mental disorders and dementia.
Simultaneous onset of diarrhea or vomiting or excessive sweating, which intensifies dehydration, will increase the risk of dehydration. This disorder is not very common, but it can be associated with important complications if not properly diagnosed and treated.
Complications of ADH Disorder Syndrome
- Increased blood sodium or hypernatremia:
Doctors call a condition in which blood sodium levels are higher than normal hypernatremia.
Complications of hypernatremia in people who do not drink enough water include:
Usually, this complication is more common in people with central SIADH. ADH is secreted from the back of the pituitary gland and enters the bloodstream and reaches the kidneys through the bloodstream. By acting on the kidneys, it causes thin and bulky urine to be produced by the kidneys and not excreted.
Causes of SIADH
SIADH can occur for two general reasons:
Factors that reduce or not produce ADH; this category is called central SIADH.
- Primary causes:
It is caused at birth by genetic abnormalities in the gene responsible for ADH production.
- Secondary causes:
Brain tumors, Trauma to the brain, Brain surgeries, Brain infections, Intracranial hemorrhage, Hydrocephalus
Factors that cause the effect of ADH on the kidneys to disappear This group is called Nephrogenic SIADH or peripheral:
- Hereditary causes
- Acquired causes:
The kidneys have disorders that cannot thicken the urine:
- Kidney kidneys
- Kidney infections
- Some cancers
Hypernatremia is more common in central causes, and peripheral causes are often associated with renal impairment and problems.
Below are the causes that can lead to acquired nephrogenic SIADH
Elevated blood calcium levels are called hypercalcemia, which is usually caused by certain cancers.
Doctors call low blood potassium levels hypokalemia
- Types of lung tumors
- Gastrointestinal tumors such as gastric adenocarcinoma
- Types of tumors of the genital system
- Especially lithium
- Amphotericin B
- Orly Statet
- Pulmonary heart bypass
- And some rare diseases such as:
Amyloidosis (a rare metabolic disease)
Sjogren’s syndrome (endocrine autoimmune disease)
Bardet Biddle Syndrome (genetic disorder related to cell lashes)
Also the following factors:
- Lung tissue infections
- Multiple sclerosis
- Cystic fibrosis
- Rocky Mountain spot fever
- Guillain-Barré syndrome
Tasteless diabetes in pregnancy
Although this complication is rare, but it is important to know and diagnose it, in this situation, a pregnant woman will be very thirsty to drink water.
Diabetes mellitus can be treated during pregnancy and also improves up to three weeks after delivery and placental abruption.
This is because, especially in the last trimester of pregnancy, the placenta secretes a substance that causes the mother to lose the hormone ADH.
Diagnosis of ADH disproportionate secretion syndrome
- Water deprivation test:
It should be done under the supervision and only with the prescription of a specialist doctor. Also, people with mental health problems may feel thirsty and drink water despite strict instructions. During the test, the concentration of the urine sample and the measurement of substances in the blood, especially blood sodium, are measured.
In this test, in a person with diabetes mellitus or ADH, the blood sodium concentration is high but the urine is dilute.
ADH hormone nasal spray, also called vasopressin, is now used to differentiate the central type from the nephrogenic type.
If using this spray, the concentration of urine in a person becomes normal, it means that it is a lack of hormone that has caused his diabetes insipidus.
If, despite the spray, the concentration of urine does not rise, it means that there is a problem with the kidneys that cannot be affected by the available hormone.
Other tests include:
- Measurement of the following substances in the blood
- Blood serum osmolality
- Blood creatinine
- Blood glucose
- Blood uric acid
- Blood cortisol
- And sodium, potassium, chlorine and bicarbonate, and blood calcium
Treatment of diabetes mellitus or ADH
The first step is to control the amount of fluid you drink
And pharmacological measures include:
- Furosemide (Lasix)
Non-pharmacological treatments include:
- Be sure to drink the right fluids:
According to the prescription and opinion of the treating physician, you should use adequate water with sufficient electrolyte.
- Control the amount of water you drink:
Your urine should be pale yellow, neither too dull nor too dark.
If you do exercise, drink eight to ten ounces, or about two hundred cc, of water a quarter of an hour before you start exercising, and repeat each quarter up to eight times during your workout.
- Follow a proper diet under the supervision of a doctor
- If you have professional sports activities or excessive sweating in hot weather, be sure to use special sports drinks under the supervision of your doctor.
One teaspoon (5 ml) of table salt or sea salt contains about 2300 mg of sodium, and most health professionals recommend that most adults who have no heart or kidney problems should limit their salt intake to the same amount. . (If healthy, 2300 mg per day or if you have heart disease, no more than 1500 mg per day.)