Endocrine Abstracts

35-year lady with BMI of 43 was admitted to local hospital after acute shortness of breath. History of Right calf pain and swelling was evident which raised suspicion of VTE with high likelihood of Pulmonary Embolism. Subsequent CT Pulmonary Angiogram confirmed the same with origin of clot from her leg DVT. She had successfully thrombolysis in intensive care as per hospital protocol. Her high body mass index was thought to be risk factor for blood clots. Her periods were regular and Inpatient pregnancy test was negative. Covid swab was negative. Routine biochemistry revealed persistent high sodium level. In patient blood glucose levels were normal. She was discharged home after intravenous fluids, analgesics and advised to continue Rivaroxaban for 6 months. OP follow up sought by patient herself due to persistent nocturia and polydipsia. Her main concern was Diabetes. Detailed history revealed frequent headache episodes and disturbed sleep due to nocturia. Her serum sodium level was consistently above 160 with total urine output ranging from 8-9 liters. Fasting urine osmolality revealed her inability to concentrate urine with strong suspicion of Central Diabetes Insipidus. We started her on oral Desmopressin, the dose of which was titrated upwards on follow up visits. Rest of anterior pituitary hormonal profile was satisfactory. MRI pituitary scan was consistent with lymphocytic infundibular neurohypophysitis. We hypothesized the relative dehydration due to polyuria contributed to prothrombotic milieu which resulted in widespread thromboembolism.