Open AccessTriamterene in lithium-induced nephrogenic diabetes insipidus: a case report
Author(s) -
Megumi Inoue,
Kentaro Nakai,
Koji Matsumoto
Publication year - 2020
Publication title -
cen case reports
Language(s) - English
Resource type - Journals
ISSN - 2192-4449
DOI - 10.1007/s13730-020-00517-2
Subject(s) - nephrogenic diabetes insipidus , medicine , triamterene , polyuria , cinacalcet , diabetes insipidus , lithium (medication) , urology , endocrinology , nephrology , hyperparathyroidism , secondary hyperparathyroidism , parathyroid hormone , hydrochlorothiazide , diabetes mellitus , calcium , blood pressure
Lithium-induced nephrogenic diabetes insipidus (NDI) is a rare and difficult-to-treat condition. We describe the case of an 81-year-old woman with bipolar treated with lithium and no previous history of diabetes insipidus. She was hospitalized due to disturbance of consciousness and was diagnosed with, hypercalcemia, hyperparathyroidism, and NDI. Parathyroidectomy was contraindicated and parathyroid hormone level was improved insufficiently after cinacalcet initiation, percutaneous ethanol injection therapy was performed for the enlarged parathyroid gland. After improvement in hypercalcemia and unsuccessful indapamide treatment, triamterene was administrated to control polyuria. Lithium is one of the indispensable maintenance treatment options for bipolar disorder, but it has the side effect of NDI. Lithium enters the collecting duct's principal cells mainly via the epithelial sodium channel (ENaC) located on their apical membranes, ENaC shows high selectivity for both sodium and lithium, is upregulated by aldosterone, and inhibited by triamterene. To our knowledge, this is the first publication on triamterene use in lithium-induced NDI patients.