Lithium-induced Nephrogenic Diabetes Insipidus with Efficacy of Desmopressin in Combination with Thiazide Diuretics and Non-steroidal Anti-inflammatory Drugs: A Case Report with a Review of the Literature

Nephrogenic diabetes insipidus (NDI) is characterized by excessive urination and an inability to concentrate urine. Lithium is the most common cause of acquired NDI. Treatment typically involves thiazide diuretics and nonsteroidal anti-inflammatory drugs (NSAIDs). However, the efficacy of desmopressin in NDI remains unclear. We herein report a case of lithium-induced NDI in a 71-year-old woman with lithium-induced NDI. Thiazide diuretics and NSAIDs reduced the urine output by approximately 40% compared to pretreatment, while the addition of desmopressin reduced it by approximately 70%. This case suggests that desmopressin can be a viable treatment option for lithium-induced NDI.

Fossil record of echinoderm regeneration with special regard to crinoids

Regeneration of skeletal parts of fossil echinoderms is reviewed. Among regenerations of various fossil echinoderms, those of crinoids are most common and many examples have been reported. Mesozoic and Cenozoic crinoids, the subclass Articulata, are characterized by the dominance of muscular articulations in the arms and they have only a small number of ligamentary articulations in localized positions that are specialized for autotomy. The dominance of muscular articulations is most conspicuous in the family Isocrinidae and comatulid (stalkless) crinoids. Most of the regenerated arms of articulate crinoids start on this ligamentary articulation. In contrast, most Paleozoic crinoids have many more ligamentary articulations and fewer muscular articulations in their arms than the Mesozoic to Recent crinoids. The ligamentary articulations of Paleozoic crinoids were probably not capable of autotomy. Fossil and recent stalked crinoids provide data on the degree and style of regeneration after loss of body parts. If the aboral nerve center in the basal part of crown is retained, the entire calyx and arms can be regenerated. In contrast, if the aboral nerve center is lost and only the stalk is preserved, some skeletal parts can only be generated imperfectly and irregularly. This type of imperfect regeneration is better termed as overgrowth.