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BMC Nephrol. 2019 May 14;20(1):168. doi: 10.1186/s12882-019-1343-9.

Partial nephrogenic diabetes insipidus associated with Castleman's disease.

Author information

1
Department of Internal Medicine, Chonnam National University Medical School, 42 Jebongro, Gwangju, 61469, Republic of Korea.
2
Department of Internal Medicine, Chonnam National University Medical School, 42 Jebongro, Gwangju, 61469, Republic of Korea. laminion@hanmail.net.

Abstract

BACKGROUND:

Nephrogenic diabetes insipidus (DI) secondary to a urinary tract obstruction is a rare condition. Herein, we report a case of partial nephrogenic DI due to obstructive uropathy in a patient with Castleman's disease.

CASE PRESENTATION:

A 78-year-old man underwent computed tomography (CT) at his local hospital because of persistent edema of the leg and polyuria (both lasting approximately 2 months); retroperitoneal fibrosis was detected on the CT scan. An abdominal CT scan showed bilateral hydronephrosis, and a surgical biopsy of the para-aortic lymph node revealed Castleman's disease. To resolve the hydronephrosis, a double J stent was inserted; however, his polyuria continued. As his serum osmolality (311 mOsm/kg) was greater than 300 mOsm/kg, and his serum sodium level was 149 mEq/L, a water deprivation test was not performed. On a vasopressin challenge test, his urine was not sufficiently concentrated to the expected range, indicating partial nephrogenic DI. He was treated with hydrochlorothiazide (25 mg/day), and his urine output gradually decreased to within the normal range. The patient recovered uneventfully and underwent treatment for Castleman's disease.

CONCLUSION:

To the best of our knowledge, this is the first case of partial nephrogenic DI due to obstructive uropathy associated with Castleman's disease.

KEYWORDS:

Castleman’s disease; Nephrogenic diabetes insipidus; Obstructive uropathy

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