Central diabetes insipidus complicating near-drowning

Abstract

Central diabetes insipidus (DI) is a very rare sequela of near-drowning. We report this case to add to the limited existing knowledge of this highly unusual complication in this group of patients. A young female rescued from fresh water submersion developed polyuria associated with hypernatremia 4 days after the accident. Desmopressin (DDAVP) was used to control the inappropriate diuresis and stabilize her intravascular volume and tonicity. Despite satisfactory response to DDAVP, she remained in a comatose state and cardiac arrest supervened 18 days after the accident. Central DI should be considered in near-drowning patients with polyuria, and needs to be treated even in those with a dismal prognosis as this would facilitate the diagnosis of brain death. This might be of relevance to communities and medical institutions where the lawful procurement of human organs in optimal conditions for transplantation is a clinical priority.