Diabetes insipidus - a disease caused by insufficient production of antidiuretic hormone vasopressin.
Vasopressin with oxytocin accumulate in the posterior pituitary, but their place of education is the hypothalamus. The hormones are synthesized in the hypothalamus and the long spikes of cells of the hypothalamus reach the posterior pituitary, where it accumulates in the final sections of processes of cells of the hypothalamus. Hence, the hormones secreted into the bloodstream and cerebrospinal fluid.
Vasopressin, or antidiuretic hormone is the main substance in the human body regulates water balance and osmotic composition of body fluids. Osmotic equilibrium liquid part of blood and extracellular fluid must be constantly maintained at a certain level, otherwise the body ceases to function. When the osmolarity of blood plasma and increased thirst appears production of vasopressin. Under the influence of vasopressin increases water reabsorption in the renal tubule, the amount of urine output decreases.
Stimulates the secretion of vasopressin also:
reduction of potassium and calcium
increase the amount of sodium in the blood
decrease in blood pressure
increase in body temperature
nicotine
morphine
epinephrine.
Reduce the allocation of antidiuretic hormone:
increase in blood pressure
lowered body temperature
beta-blockers
alcohol
Clonidine
haloperidol
karbomazepin.
In addition to regulating the osmotic pressure of vasopressin:
involved in the maintenance of blood pressure
regulates the secretion of some hormones
helps blood to clot
in the central nervous system is involved in the process of remembering.
Hypothalamic diabetes insipidus, diabetes or central origin violation occurs when production of vasopressin cells of the hypothalamus.
Insipidus, nephrogenic (kidney), diabetes occurs when the kidney fails sensitivity to vasopressin, in normal amounts in the blood. When diabetes insipidus kidneys secrete large amounts of urine with low specific weight. That is, in the urine is present in most water and the amount of salts and other substances dramatically reduced. Isolation of large amounts of fluid by the kidneys causes a compensatory increased thirst.
The causes of diabetes insipidus central origin are the hereditary nature of, various diseases of the central nervous system:
sarcoidosis
malignant tumors
Metastasis
infectious diseases
meningitis
encephalitis
syphilis
autoimmune diseases
vascular disorders
kraniofaringeoma
aneurysm of the brain.
Diabetes insipidus may occur after injury of skull and brain, after surgery on the brain, especially after the removal of pituitary adenomas. The disease occurs with equal frequency in both men and women.
Clinical manifestations of diabetes insipidus.
Early signs of disease were to increase the volume of urine up to 5-6 liters per day, increased thirst. The patient has to drink the same amount of liquid. There are nocturnal urge to urinate, and associated sleep disturbance, fatigue. Patients usually prefer to drink cold, with ice fluid. Further, the amount of urine may be increased to 20 liters.
The patient's condition worsens:
headache
xerosis
loss of flesh
decrease in salivary secretion
tension and the omission of the stomach.
The symptoms of the gastrointestinal tract. There is a stretching of the bladder. Appears quickening heart rate, blood pressure reduction. In newborns and infants condition can be severe:
there is unexplained vomiting
increase in body temperature
neurological disorders.
In older children, there is urinary incontinence (enuresis).
Treatment of diabetes insipidus.
For the treatment of diabetes insipidus as replacement therapy used a synthetic analogue of vasopressin - adiuretin diabetes or desmopressin. It is introduced intranasally (through the nose) twice a day.
There is a long-acting drug - pitressin Tanat. It is used once in 3-5 days.
In addition, we recommend a diet with increasing amounts of consumed carbohydrates and frequent meals. To increase the secretion of antidiuretic hormone used chlorpropamide, karbomazepin.
If nephrogenic diabetes insipidus are assigned thiazide diuretics, lithium.
If you find a brain tumor treatment often operative. Disease is a long, long-term. At the appointed time the treatment prognosis for life is good.
