1. Central diabetes insipidus induced by temozolomide: A report of two cases
- Author
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Nicolas Whenham, Cédric Mahiat, Lionel Duck, Thierry Duprez, Antoine Capes, Laura Labriola, UCL - SSS/IREC/NEFR - Pôle de Néphrologie, UCL - SSS/IONS/NEUR - Clinical Neuroscience, UCL - (SLuc) Service de radiologie, UCL - (SLuc) Service d'oncologie médicale, UCL - (SLuc) Service de néphrologie, and UCL - (SLuc) Centre du cancer
- Subjects
Adult ,Male ,0301 basic medicine ,desmopressin ,medicine.medical_specialty ,Vasopressins ,Diabetes insipidus ,030209 endocrinology & metabolism ,temozolomide ,Urine ,03 medical and health sciences ,Fatal Outcome ,0302 clinical medicine ,Internal medicine ,Temozolomide ,medicine ,Humans ,Deamino Arginine Vasopressin ,Pharmacology (medical) ,Desmopressin ,Antineoplastic Agents, Alkylating ,Brain Neoplasms ,business.industry ,Middle Aged ,medicine.disease ,Diabetes Insipidus, Neurogenic ,030104 developmental biology ,Endocrinology ,Oncology ,polyuria polydipsia ,Glioblastoma ,business ,hormones, hormone substitutes, and hormone antagonists ,Hormone ,Antidiuretic ,medicine.drug - Abstract
Introduction Central diabetes insipidus is a heterogeneous condition characterized by decreased release of antidiuretic hormone by the neurohypophysis resulting in a urine concentration deficit with variable degrees of polyuria. The most common causes include idiopathic diabetes insipidus, tumors or infiltrative diseases, neurosurgery and trauma. Temozolomide is an oral DNA-alkylating agent capable of crossing the blood-brain barrier and used as chemotherapy primarily to treat glioblastoma and other brain cancers. Cases Two men (aged 38 and 54 years) suddenly developed polyuria and polydispsia approximately four weeks after the initiation of temozolomide for a glioblastoma. Plasma and urine parameters demonstrated the presence of a urinary concentration defect. Management The clinical and laboratory abnormalities completely resolved with intranasal desmopressin therapy, allowing the continuation of temozolomide. The disorder did not relapse after cessation of temozolomide and desmopressin and relapsed in one patient after rechallenge with temozolomide. Discussion Our report highlights the importance of a quick recognition of this exceptional complication, in order to initiate promptly treatment with desmopressin and to maintain therapy with temozolomide.
- Published
- 2020
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