ACUTE-LEUKEMIA RELAPSE PRESENTING AS CENTRAL DIABETES-INSIPIDUS

Background. Diabetes insipidus due to leukemic involvement of the cent ral nervous system has been described previously in several patients. Although the timing of the diabetes insipidus onset in relation to the leukemia is variable, it has not been described previously as the fir st manifestation of leukemia relapse. Methods. Two cases of leukemia r elapse presenting as central diabetes insipidus are described and the literature is reviewed. Results. Clinical data of 29 of the 39 reporte d cases were available. The median age was 46 years, with no gender pr edominance. Seventy-three percent had acute nonlymphocytic leukemia, a nd deletion of chromosome 7 or monosomy 7 was the predominant cytogene tic abnormality. No temporal relation between the onset of diabetes in sipidus and the leukemia was found. In none of the previously reported cases was diabetes insipidus the first manifestation of the leukemia recurrence. Conclusions. The temporal relationship between diabetes in sipidus and leukemia is inconsistent. The former may precede, follow, or present concomitantly with the latter. Two cases of diabetes insipi dus as the presenting sign of leukemia relapse are reported.