A rare case report on diabetes insipidus following living donor liver transplantation in patient with alcoholic liver disease

TL;DR

A rare case of diabetes insipidus occurred after liver transplantation in a patient with alcoholic liver disease, successfully treated with desmopressin.

Contribution

Highlights a rare post-transplant complication and the importance of individualized diagnostic strategies in liver transplant recipients.

Findings

Nephrogenic diabetes insipidus occurred post-transplant despite normal brain imaging and elevated antidiuretic hormone levels.

Desmopressin therapy led to rapid symptom resolution and full recovery.

Emphasizes the need for clinical assessment and biochemical markers in diagnosing DI in transplant patients.

Abstract

A rare occurrence of nephrogenic diabetes insipidus (DI) following liver transplantation despite elevated plasma antidiuretic hormone
levels and normal brain imaging findings is of interest. On the sixth day post-transplantation, the patient developed polyuria, a hallmark
symptom of DI, prompts a comprehensive differential diagnosis. Desmopressin therapy was initiated, leading to rapid symptom resolution and
full recovery. This case underscores the diagnostic challenges of DI in liver transplant recipients, particularly in differentiating between
central and nephrogenic forms. Conventional diagnostic tests for DI, like water deprivation, are not preferred in patients receiving liver
transplantation. Therefore, clinical assessment, biochemical markers, and imaging play a crucial role in diagnosis. The patient was successfully
managed with desmopressin, thus emphasizing the importance of early recognition of symptoms and prompt initiation of treatment to prevent
complications in liver transplantation patients to ensure optimal outcomes. Thus, we show the potential for rare post-transplant complications
and the need for individualized diagnostic and therapeutic strategies.