Endocrine Case Study Patient History A 28 year old male complained of excessive

Question

Endocrine Case Study

Patient History

A 28 year old male complained of excessive thirst and an increase in urinary volume. Lab results showed the following

urine specific gravity (relative density) was less than 1.005 (normal: 1.040 - 1.050)

urine osmolarity (concentration) was less than 200 mOsm/L (normal: 500 - 800 mOsm/L)

urinary volume was 15 L/day (normal: 1.5 to 3.0 L)

serum sodium was 145 mEq/L (normal: 136 - 145 mEq/L)

serum potassium was 2.8 mEq/L (normal: 3.6-5.1 mEq/L)

Water deprivation and hypertonic saline infusion did not cause a significant reduction in urinary volume or urinary osmolarity:

a urine specific gravity (relative density) of 1.009

a urine osmolarity (concentration) of 225 mOsm/L

However, there was a significant increase in the concentration of the urine and decrease in urinary output following administration of ADH.

Questions:

1.What condition is the patient suffering from

2.Why did the water deprivation and hypertonic saline infusion not result in a concentrated urine?

3.Describe the location of the disorder in this individual. Is the defect related to the lack of receptors or the lack of hormone; explain your answer?

4.How might the patient be treated for his condition, explain your answer

5.Draw out the negative feedback pathway for the hormone involved

Explanation / Answer

1. The patient is suffereing from Polydipsia and Polyuria

2. The response of Kidneys to the Anti Diuretic Hormone is affected so the kidneys are not able to respond the high water intake and hence there is decrease in the ability of the kidneys to concentrate urine by Water deprivation and Hypertonic Saline infusion.

3. The location is the Kidneys. This is due to lack of hormone which is Vassopressin (ADH)

4. He/she should follow a low proteint - diet with low levels of Calcium . Vassopressin(ADH) should be taken in the form of sprays which contain ADH.

5. The negative feedback pathway will be for ADH hormone which enters into the kidneys but are not processed by the kidneys

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