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CASE REPORT article
Front. Med.
Sec. Translational Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1498731
Rapid-Onset Hypernatremia Induced by Central Diabetes Insipidus Leading to Osmotic Demyelination Syndrome: A Case Report A Case Report
Provisionally accepted- Shenzhen Baoan People's Hospital, Shenzhen, China
This case study describes a middle-aged male patient who developed persistent hypernatremia due to central diabetes insipidus (CDI), presenting with polyuria (up to 8.5L/24h), polydipsia, and hypotonic urine (urine specific gravity <1.005). A positive response to the desmopressin test confirmed the diagnosis of CDI. The excessive loss of body water led to a peak serum sodium level of 195 mmol/L, resulting in Osmotic demyelination syndrome (ODS), clinically manifesting as sluggish responses and symmetrical limb paralysis. The patient was treated with hypotonic fluid replacement combined with desmopressin while ensuring a controlled reduction in serum sodium levels (≤10 mmol/L within 24 hours). As a result, as serum sodium and urine output gradually normalized, the patient's consciousness and limb strength progressively recovered. This case highlights the risk of ODS in patients with severe hypernatremia caused by CDI. A slow and controlled correction of serum sodium levels is crucial in preventing cerebral edema, and early rehabilitation plays a vital role in improving
Keywords: Hypernatremia, Central diabetes insipidus, Osmotic Demyelination Syndrome, case report, Sodium correction
Received: 26 Sep 2024; Accepted: 25 Mar 2025.
Copyright: © 2025 Zhang, Chen, Kong, Yan and Su. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Shengyuan Su, Shenzhen Baoan People's Hospital, Shenzhen, China
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