# A Case of Hypernatremia in a Newly Diagnosed Patient With Acute Myeloid Leukemia: Lessons for Nephrologists

## TL;DR

A patient with newly diagnosed acute myeloid leukemia developed severe hypernatremia due to arginine vasopressin deficiency, highlighting the importance of recognizing this rare but critical condition.

## Contribution

This case emphasizes the underappreciated link between acute myeloid leukemia and arginine vasopressin deficiency, offering insights for clinicians.

## Key findings

- A 39-year-old patient with acute myeloid leukemia developed severe hypernatremia due to arginine vasopressin deficiency.
- Diagnostic testing with desmopressin and copeptin confirmed the deficiency, guiding appropriate treatment.

## Abstract

Arginine vasopressin deficiency (AVP-D), formerly known as central diabetes insipidus, is a disease characterized by polyuria, polydipsia, and hypernatremia. The concomitant diagnosis of acute myeloid leukemia (AML) is an underappreciated event that requires prompt recognition and treatment by practicing nephrologists and hematologists. This report highlights this importance by describing the case of a 39-year-old patient newly diagnosed with AML who developed severe hypernatremia. The role of diagnostic testing through desmopressin (DDAVP) challenge and copeptin testing to confirm the diagnosis of AVP-D in this context and the use of DDVAP for treatment are discussed. Practicing nephrologists and primary care providers taking care of patients with similar symptoms will benefit from understanding the pathophysiology of AVP-D, its relationship with AML, and the prognosis in this patient cohort.