Endocrine Abstracts

We present the case of a 54-year-old female who presented with a subarachnoid haemorrhage secondary to a left posterior communicating artery aneurysm in 2002 whilst in South Africa. The aneurysm was clipped in early 2003. Post operatively, she developed polyuria and polydypsia attributed to diabetes insipidus and was started on desmopressin nasal spray. Her background medical history includes hypertension, hyperlipidaemia and hypothyroidism and her medication was perindopril, moxonidine, amlodopine, thyroxine and co-codamol and DDAVP (one puff twice a day). Before the test, we confirmed that she was on appropriate thyroxine replacement and that she had no steroid deficiency.

She was referred to our Service for endocrine follow-up. We arranged a water deprivation test to assess the need for long-term DDAVP.

According to our protocol, she had her morning dose of DDAVP the day before the water deprivation test and then omitted the next dose. The patient was allowed 500 ml of water up to 06.30 am on the day of the test followed by a light breakfast. Her weight was recorded at midnight, as was her urine output. Samples were taken throughout the day for plasma and urine osmolalities with weight being recorded.

We propose to discuss the results, and demonstrate the appropriate use of DDAVP (2 mcg im) within the test.