Endocrine Abstracts

Introduction: Polyuria-polydipsia syndrome is an uncommon problem in clinical practice defined by the combination of production of ‘abnormally’ large volumes of urine (>3 L/day in adults and 2 L/m² in children) with the persistent intake of abnormally large quantities of fluids. The purpose of this study is to detail the clinical and etiological profile of polyuria-polydipsia syndrome in the Endocrinology-Diabetology Department of Oujda’s University Hospital.

Materials and Methods: A retrospective study including 10 patients with polyuria-polydipsia syndrome, excluding patients with diabetes mellitus, hypercalcemia or hypokalemia.

Results: The mean age was 22 years, with a male predominance. History of cranial trauma was noted in one patient, while another patient was treated for pleuro-pericardial tuberculosis. The endocranial syndrome was found in 3 cases and 2 cases had an associated short stature. The mean diuresis was 9.18 l/24h with a maximum of 25 l/24h. Water deprivation test was performed in 5 patients with an average duration of 5 hours. Hormonal testing revealed GH deficiency in 2 cases, thyrotrophin deficiency in 3 cases, corticotrophin deficiency in 2 cases and gonadotrophin deficiency in 2 cases. Magnetic resonance imaging of the hypothalamic-pituitary region was normal in 30% of patients and showed hypophysitis in 3 cases one of which was related to pituitary tuberculosis, germinoma in 1 case, prolactinoma in 1 case, and the posterior pituitary was not visible in 2 patients.

Conclusion: The polyuria-polydipsia syndrome diagnosis is challenging. The water deprivation test is the gold standard to differentiate between diabetes insipidus and primary polydipsia. Pituitary MRI is essential when central diabetes insipidus is suspected. Close clinical follow of idiopathic cases is mandatory to avoid diagnosis delay.