POLYDIPSIA

Ask the Following Questions:

1. Is there a history of drug ingestion? Diuretics and arsenic poisoning are among the many causes of excessive thirst.
2. Is there associated polyphagia and weight loss? The presence of these symptoms would suggest diabetes mellitus and hyperthyroidism.
3. Is there massive polyuria? The presence of massive polyuria suggests diabetes insipidus or psychogenic polydipsia.
4. Is there mild polyuria? The presence of mild polyuria should suggest chronic renal failure, renal tubular acidosis, hyperparathyroidism, and febrile illnesses.

DIAGNOSTIC WORKUP

The basic workup includes a CBC, sedimentation rate, urinalysis, 24-hr urine volume, a serum and urine osmolality, a thyroid profile, and x-rays of the skull and long bones.

The diagnosis of hyperparathyroidism may be assisted by ordering a serum parathyroid hormone level. Also, a 24-hr urine collection for calcium may be done to help diagnose this condition. Microscopic examination of the urinary sediment will help diagnose renal disease, as will renal biopsies. If pituitary diabetes insipidus is suspected, a CT scan of the brain and blood tests for serum growth hormone, FSH, LH, ACTH, and TSH may be done. The Hickey-Hare test and monitoring intake and output before and after vasopressin (Pitressin®) will be useful in differentiating pituitary diabetes insipidus from nephrogenic diabetes insipidus. The concentrations of circulating vasopressin may be measured by immunoassay.

An endocrinologist should be consulted before ordering these expensive diagnostic tests.

Book Source Details

• Book Title: Algorithmic Diagnosis of Symptoms and Signs
• Author(s): R. Douglas Collins
• Year of Publication: 2003
• Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.

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Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2008 Williams & Wilkins.

More About Causes of Thirst

• Back to symptom: Thirst: Introduction (review 171 causes)
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More About This Book: Title: Algorithmic Diagnosis of Symptoms and Signs Authors: R. Douglas Collins Publisher: Lippincott Williams & Wilkins Copyright: 2003 ISBN: 0-7817-3805-9

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