Diabetes Insipidus: A Report of Three Cases in a Tertiary Health Facility in North Western Nigeria

Background: Diabetes Insipidus (DI) is a condition characterized by excessive thirst (polydipsia) and passage of a large volume of dilute urine (polyuria).

Methods: The report was a case study involving three subjects from the Federal Teaching Hospital Kastina, Nigeria. Subjects were aged 20, 21 and 10years. All presented with polydipsia and polyuria. A clinical assessment was done. Investigations include routine laboratory and radiological assessments, thyroid function tests, blood glucose, 24hrs urine quantification, water deprivation test, and brain MRI were done among others.

Results: Two cases had primary complaints of polydipsia and polyuria while one was secondary to head trauma. All preliminary routine investigations were essentially normal. 24-hour urine collection of 18.6 litres (134mOsmol/kg), 9.6 litres (292.6mOsm/kg) and 6.9 litres (250mOsmol/kg) were reported in cases 1,2 & 3 respectively. The urine deprivation test shows a less than 50% increase in urinary osmolality after administration of DDVAP in cases 1& 2, while the urinary osmolality values continued to increase throughout the test period in case 3.

Conclusion: Partial Central Diabetes Insipidus was diagnosed in the first and second cases and were managed with desmopressin nasal spray with significant improvements. However, the third case was referred to the paediatric mental health clinic where she also responded well to treatment.