What is known and objective: Central diabetes insipidus (DI) is a complex disease that requires firm adherence to desmopressin therapy. There is little information on the onset of hypernatremia after withdrawal of desmopressin.
Case summary: We present a case of an elderly woman with central DI whose serum sodium jumped from 141 to 171 mEq/L after 48-72 h of holding oral desmopressin. Her DI crisis resolved with intravenous desmopressin and free water administration.
What is new and conclusion: Based on this precipitous onset of DI crisis, we recommend not withholding desmopressin for more than 24 h.
Keywords: central diabetes insipidus; desmopressin; hypernatremia.
© 2022 The Authors. Journal of Clinical Pharmacy and Therapeutics published by John Wiley & Sons Ltd.