SELF ASSESSMENT QUESTION

Thirst and polyuria

An interesting case of thirst and polyuria

P K Moulik, C Nethaji and A A Khaleeli

Department of Medicine, Halton General Hospital, Runcorn, Cheshire, UK

Correspondence to:
Correspondence to:
Dr P K Moulik, 39 Coniston House, University Hospital Aintree, Longmore Lane, Street, Liverpool L9 7AL, UK;
p.moulik@virgin.net

Submitted 16 October 2001

Accepted 12 November 2001

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Answers on p 251.

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Keywords: hypercalcaemia; acromegaly; Graves' disease; thyrotoxicosis; Merkel cell carcinoma; trabecular carcinoma; neuroendocrine tumour; skin lesion; erythema gyratum repens; malignancy; Wilson's disease; liver failure; hepatolenticular degeneration; alkaline phosphatase

The first 150 words of the full text of this article appear below.

A 24 year old woman presented with a three week history of weight loss, thirst, polyuria, sweating, and nausea. For three days before admission she had abdominal pains and vomiting after meals. Past medical history included acromegaly treated by trans-sphenoidal resection of a pituitary macroadenoma at the age of 19 years. Postoperatively, she did not have diabetes insipidus; however, she developed anterior hypopituitarism replaced with hydrocortisone 10 mg twice daily, thyroxine 100 µg daily, and ethinyloestradiol and desogestrel for three weeks every month. She also had persistent postoperative acromegaly that was well controlled with bromocriptine 7.5 mg daily. She had not received postoperative radiotherapy.

Clinical examination revealed postural hypotension with supine blood pressure 130/70 mm Hg and standing blood pressure 85/45 mm Hg. She was in sinus rhythm with a heart rate of 94 beats/min. Visual acuity was 6/24 in the right eye and 6/5 in the . . . [Full text of this article]

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Relevant Article

An interesting case of thirst and polyuria
Postgrad. Med. J. 2002 78: 251. [Extract] [Full Text] [PDF]