Diabetes insipidus - a rare complication of major flame burn: case report

Abstract

Background: Diabetes insipidus is a syndrome characterised by polyuria which is associated with urinary frequency, enuresis, nocturia and polydipsia. We present this case to highlight the significant role of high degree of clinical suspicion and interdisciplinary management resulting in a rewarding outcome in a limited resource environment.
Method and result: A 35year old man presented with 31% Total Body Surface Area (TBSA) flame burn injury. He was resuscitated with intravenous Ringer’s lactate. He however developed polyuria on the fifth day post burn with urinary output ranging between 2.5 – 15ml/kg/hr. Urine specific gravity ranged between 1.000 – 1.005. A clinical diagnosis of diabetes insipidus was made. He was treated with vasopressin and desmopressin and the burn wounds were managed without skin grafting. The symptoms of DI resolved at 32nd day post- burn.
Conclusion: Diabetes insipidus is a rare occurrence in patients with burns. Therefore, high index of suspicion is needed to detect and effectively manage its occurrence.

Key words: Polyuria, enuresis, frequency, nocturia, polydipsia