Abstract
Anterior pituitary hypofunction is a well-known complication following snake bite. However, central diabetes insipidus as a complication of snake bite is only rarely reported in the literature. We are reporting a case of central diabetes insipidus, which developed as sequelae to viper bite.
Highlights
This case is unique because of its rarity
There was more than 50% increase in urine osmolality and his polyuria decreased, thereby confirming a diagnosis of central diabetes insipidus
Vascular occlusion produced as a consequence of viper bite could be the cause for the central diabetes insipidus as well as hypocortisolism
Summary
This case is unique because of its rarity. There are only four case reports of central diabetes insipidus following snake envenomation. Case history A 49-year-old man was admitted with complaints of diarrhea, vomiting, and altered level of consciousness. He gave a history of viper bite followed by acute kidney injury about 4 months back. He complained of severe fatigue and was noticed to have urine output of around 6 l/day His blood sugar was 146 mg%, serum creatinine was 0.7 mg%, urine osmolality was 174 mosmol/kg, plasma osmolality was 332 mmosmol/kg, and serum sodium was 147 mmol/l. Free T3 was 4.5 pg/ml (1.2–4.2 pg/ml), free T4 was 47 pg/ml (9–22 pg/ml), thyroid-stimulating hormone was 0.01 μIU/ml (0.4–4.2 μIU/ml), and serum cortisol was 2.6 μg/ml (4.3–22.4 μg/ml)
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