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  • Title: Hyperosmolar nonketotic coma precipitated by lithium-induced nephrogenic diabetes insipidus.
    Author: Azam H, Newton RW, Morris AD, Thompson CJ.
    Journal: Postgrad Med J; 1998 Jan; 74(867):39-41. PubMed ID: 9538487.
    Abstract:
    A 45-year-old man, with a 10-year history of manic depression treated with lithium, was admitted with hyperosmolar, nonketotic coma. He gave a five-year history of polyuria and polydipsia, during which time urinalysis had been negative for glucose. After recovery from hyperglycaemia, he remained polyuric despite normal blood glucose concentrations; water deprivation testing indicated nephrogenic diabetes insipidus, likely to be lithium-induced. We hypothesize that when this man developed type 2 diabetes, chronic polyuria due to nephrogenic diabetes insipidus was sufficient to precipitate hyperosmolar dehydration.
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