Four cases of diabetes insipidus and pulmonary disease.

The syndrome of diabetes insipidus may arise from many different lesions of the hypothalamohypophyseal mechanism. Destruction of the posterior .lobe of the pituitary gland, the hypothalamo-hypophyseal tract, or the supra-optic nuclei bilaterally will produce the symptoms of polyuria and polydipsia, provided the anterior lobe of the pituitary gland remains functionally intact. It is a r-are affection. In the majority of cases the pathological cause of the diabetes insipidus can be deduced during life, but there remains a small group of cases in which this is not possible. This communication is concerned with the association of diabetes insipidus with diffuse pulmonary disease in four patients. The first patient was undoubtedly suffering from sarcoidosis in that he fell ill with fever, facial palsy, and uveoparotitis (Heerfordt), recovered, and later developed pulmonary disease and diabetes insipidus. The latter necessitated treatment with pitressin for 18 months. The second and third patients suffered from permanent diabetes insipidus and chronic . pulmonary "fibrosis" of obscure origin. The third patient showed progressive intellectual deterioration and his electroencephalogram was abnormal. In the fourth* patient diagnosis is not yet established, but sarcoidosis cannot be excluded.