著明な尿路拡張を伴つた特発性尿崩症の1例

IDIOPATHIC DIABETES INSIPIDUS ACCOMPANIED BY MASSIVE DILATATION OF THE URINARY TRACT

はじめに

　尿崩症のように大量の尿が，長期にわたり排泄された場合，尿路の尿運搬機能がこれに対応しきれずに，尿路拡張を来すことがあることは以前より指摘されているが，臨床的に遭遇することはまれである。われわれは最近，多尿のために起こつたと考えられる著明な尿路拡張を伴つた尿崩症の1例を経験したので報告する。

A 26-year-old man was admitted to Niigata City Hospital on August 25, 1975 because of left flank pain, polydypsia and polyuria. Urologic studies revealed massive bilateral hydronephrosis, hydroureter and enlarged bladder without obstruction of the bladder outlet and urethra. The 24-hour urinary output varied from 8200 to 15500 ml, with specific gravity of 1. 005 and 1. 006. After failure of reduction of urinary output by either water deprivation or hypertonic saline infusion, 5 units pitressin tannate in oil was injected which produced a dramatic reduction of urinary flow with a marked rise in urinary osmo-larity.