TRANSIENT CENTRAL DIABETES-INSIPIDUS IN THE SETTING OF UNDERLYING CHRONIC NEPHROGENIC DIABETES-INSIPIDUS ASSOCIATED WITH LITHIUM USE

Nephrogenic diabetes insipidus (NDI) is a well-documented complication of lithium use. The association of central diabetes insipidus (CDI) w ith lithium use is rare. We report a patient receiving chronic lithium therapy who presented with a transient CDI occurring in the setting o f underlying chronic NDI, To the best of our knowledge, this is the fi rst case of lithium-associated CDI and NDI presenting concurrently. Po tential mechanisms regarding the pathophysiology of lithium-associated CDI are discussed, This case emphasizes the importance of the evaluat ion of lithium-associated polyuria with a direct measurement of plasma vasopressin, interpreted with simultaneous plasma and urine osmolalit y to secure the correct diagnosis and ensure appropriate therapeutic m anagement.