Case Report


Central diabetes insipidus as a manifestation of cerebral edema in a patient with SARS-CoV-2 infection

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1 Renal Physicians Inc., 500 Lincoln Park Blvd, Kettering, OH, USA

2 Department of Internal Medicine, Kettering Medical Center, 3535 Southern Blvd, Kettering, OH, USA

Address correspondence to:

Nilesh Mhaskar

500 Lincoln Park Blvd, Kettering, OH 45429,

USA

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Article ID: 101241Z01NM2021

doi: 10.5348/101241Z01NM2021CR

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How to cite this article

Mhaskar N, Gilbert ZA. Central diabetes insipidus as a manifestation of cerebral edema in a patient with SARS-CoV-2 infection. Int J Case Rep Images 2021;12:101241Z01NM2021.

ABSTRACT


SARS-COV-2, the virus responsible for coronavirus disease 2019 (COVID-19), has been associated with various clinical manifestations ranging from an asymptomatic carrier state to pneumonia and respiratory failure, encephalopathy, thromboembolic events, and death. The objective of this case report is to highlight an additional complication possible with COVID-19: central diabetes insipidus (CDI) in the setting of fulminant cerebral edema. A 66-year-old male presented with cough, shortness of breath, and fever and was found to have COVID-19 pneumonia. During the hospitalization, he developed acute hypernatremia with a significant increase in urine output associated with low urine osmolarity. Central diabetes insipidus was confirmed by administration of desmopressin. The presence of CDI along with worsening neurologic changes prompted cerebral imaging revealing intraparenchymal hemorrhages and significant edema. To our knowledge, this is the first report of CDI caused by cerebral edema in a patient with COVID-19. We present this rare association to help alert clinicians to the possibility of polyuria and CDI as a sign of potentially fatal neurologic sequelae of COVID-19.

Keywords: Central diabetes insipidus, Cerebral edema, COVID-19, SARS-COV-2

SUPPORTING INFORMATION


Author Contributions

Nilesh Mhaskar - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Final approval of the version to be published

Zachary A Gilbert - Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Guarantor of Submission

The corresponding author is the guarantor of submission.

Source of Support

None

Consent Statement

Written informed consent was unable to be obtained as the patient is deceased from disease process and was not required by the local IRB. No protected health information or patient-identifying information is present in the article and every attempt was made to protect the identity of the patient.

Data Availability

All relevant data are within the paper and its Supporting Information files.

Conflict of Interest

Authors declare no conflict of interest.

Copyright

© 2021 Nilesh Mhaskar et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.