A patient with a malignancy may develop diabetes insipidus (DI) for a number of reasons.


The most common cause of DI is a tumor (primary or metastatic) to the region of the pituitary or hypothalamus.


Additional reasons for DI include:

(1) renal failure due to obstructive uropathy

(2) renal disease associated with amyloidosis

(3) other causes of renal failure

(4) drug-induced nephrogenic diabetes insipidus (cyclophosphamide, other)

(5) drug-induced reduction in the secretion of antidiuretic hormone (ADH)


Wassermann hypothesized the possibility of a small cell undifferentiated carcinoma of the lung metastasizing to the pituitary and also secreting an ADH-like peptide with decreased functional activity. This would result in a normal antigenic assay for ADH yet diabetes insipidus.


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