Nephrogenic Diabetes Insipidus Due to Sarcoidosis Without Hypercalcemia

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Abstract
A previously healthy young man presented with disabling polyuria and polydipsia. The diagnosis of generalized sarcoidosis was established by typical radiologic and histologic findings including a positive Kveim test. Renal biopsy showed diffuse parenchymal involvement with microgranulomatous lesions. Hypercalcemia, hypercalcuria and renal failure were never present. Response to hypertonic saline and vasopressin administration and to dehydration was abnormal and indicated renal tubular vasopressin resistance. Nephrogenic diabetes insipidus not associated with hypercalcemia has not previously been reported as a complication of sarcoidosis. The polyuria responded only minimally to low solute intake and chlorothiazide. An apparent complete remission was achieved by treatment with corticosteroids.