ECE2023 Eposter Presentations Pituitary and Neuroendocrinology (234 abstracts)
Polyuria-polydipsia syndrome revealing primary potomania : a diagnostic challenge
Najoua Lassoued 1 , Fatma Zaouali 2 , Arige Abid 1 , Yassmine Abdelkafi 1 , Mahmoud Alzir 2 , Zantour Baha 1 & Sfar Mohamed Habib 1
1Tahar Sfar University Hospital, Endocrinology Department, Mahdia, Tunisia; 2University of Monastir, Family Medicine Department, Monastir, Tunisia
Introduction: Polyuria-polydipsia syndrome (PUPDS) requires a comprehensive diagnostic approach as it can reveal serious medical conditions. We report the case of a patient consulting for PUPDS related to a primary potomania.
Case presentation: A 41-year-old patient with a history of multiple psychostimulants use was admitted for acute PUPDS after emotional shock and paucisymptomatic SARS-CoV-2 infection. Diuresis was estimated at 6 liters per 24 hours. During the interview, the patient reported psychostimulants withdrawal for over a year. He did not have tumor syndrome. Urinary density was <1005. A brain MRI was performed showing persistent hyperintensity on T1-weighted image of the posterior pituitary, ruling out a diagnosis of central diabetes insipidus. However, this diagnosis was not entirely ruled out by the hypothesis of acute-onset ADH deficiency due to COVID-19 infection. Given the importance of PUPDS, the patient was given desmopressin with marked clinical improvement. A Fluid deprivation test was done two months later. The patient concentrated his urine and ADH level was normal. Therefore the diagnosis of primary potomania was maintained and the patient was referred to psychiatric clinic.
Discussion: Primary potomania is a psychopathology that represents a differential diagnosis with diabetes insipidus and remains a diagnosis difficult to maintain until another organic cause is ruled out.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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