Central essential hypernatremia: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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Causes of central essential hypernatremia
The causes of hypernatremia may be, in addition to the forms of diabetes insipidus, an isolated loss of thirst (some organic lesions of the central nervous system are craniopharyngiomas, pinealomas, meningiomas, hydrocephalus, cysts of different localization), restriction of fluid intake as a result of a particular life situation or due to a severe condition (coma) sweating, excessive sodium intake with food, excessive sodium retention in hyperaldosteronism.
Pathogenesis of central essential hypernatremia
It is believed that there is a dysfunction of the osmoreceptor centers of the hypothalamus. In pathoanatomical research, neither micro- nor macrostructural lesions of the hypothalamus and pituitary gland are detected.
Symptoms of central essential hypernatremia
Central essential hypernatremia is manifested by chronic hypernatremia, moderate degree of dehydration and hypovolemia. It often occurs at the subclinical level. Possible phenomena of adiptsia without polyuria. As a rule, a somewhat lowered level of antidiuretic hormone corresponds to the state of hypovolemia. Some authors consider this syndrome to be a partial form of diabetes insipidus.
Differential diagnosis should be carried out with the full form of diabetes insipidus of both neurogenic and nephrogenic genesis, with hypernatremia, possible with diabetes mellitus, with hyperaldosteronism.
Treatment of central essential hypernatremia
A long-term salt-free diet is needed, sufficient drinking. In other manifestations of diabetes insipidus, appropriate treatment is prescribed.
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