Non-psychogenic polydipsia in 45-year-old man with primary hyperparathyroidism and recurrent bilateral nephrolithiasis

Abstract

Abstrak AbstractNon-psychogenic polydipsia with hyponatremia is a rare clinical presentation. Primary hyperparathyroidism is a disorder of calcium, phosphate, and bone metabolism caused by increased level of parathyroid hormone (PTH). It is estimated the incidence of primary hyperparathyroidism are 21.6 per 100,000 person a year. This case report describe a 45-yearold man presented with non-psychogenic polydipsia. This patient drank a lot of water out of the fear of recurrent kidney stones. He had history of recurrent nephrolithiasis with hypercalcemia. We investigate further the cause of hypercalcemia and we diagnosed primary hyperparathryoidism as the cause.

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“…The hypothalamus, which is found in the brain is essential in controlling body water. We become thirsty when more than 0.5% of the body water is lost in various ways [8]. The kidneys are capable of removing about 20 -28 L of water a day to control water load and hence excessive water ingestion rarely causes hyponatremia [8].…”

“…We become thirsty when more than 0.5% of the body water is lost in various ways [8]. The kidneys are capable of removing about 20 -28 L of water a day to control water load and hence excessive water ingestion rarely causes hyponatremia [8]. However, a decrease in serum sodium inhibits antidiuretic hormone (ADH) secretion by the posterior pituitary gland and results in an increase in excretion of water by the kidneys.…”

“…However, a decrease in serum sodium inhibits antidiuretic hormone (ADH) secretion by the posterior pituitary gland and results in an increase in excretion of water by the kidneys. Hyponatremia develops only when the water intake exceeds the water excretory capacity of the kidneys [8][9][10]. The maximum amount of water that a healthy renal system can tolerate is 0.8 -1 L/h to avoid symptoms of hyponatremia [3].…”