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Diabetes Insipidus in Young Women with Cervical Cancer

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Diabetes Insipidus in Young Women with Cervical Cancer

Bram Pradipta, Laila Nuranna

Abstract


AbstractA 25 year old, unmarried, Indonesian woman came to the emergency department Cipto Mangunkusumo Hospital with shock condition. Initially assessed as septic condition, the patient was then diagnosed as diabetes insipidus (DI). It was concurrently found that the patient also had several sexual intercourse before and not until later that the patient diagnosed with stage IB cervical cancer. Cervical cancer (CC) is the third most common cancer in women worldwide and primarily affects young adult women, with consequences not only individually but also socially. DI is a rare disease that causes frequent urination that is not freqently related with CC. Concurrent incidence of DI with CC can only be seen in several case reports. It has not yet been established whether these two conditions are concurrent or having a cause-effect relationship. DI is not a common case, hence knowing its clinical sign and syptoms are very important. In fund limited setting in third world countries, the laboratory examination can be simplified by examining the osmolality of the serum and urine condition. These low level of serum can be very helpful in diagnosing  DIwith  treatment can be as simple as fluid restriction. Regarding the CC, radical trachelectomy can be done with surveilance must be done every 3-6 month for 2 years and every 6-12 month for 3-5 years with cytology.Keywords: CC, diabetes insipidus
AbstrakSeorang perempuan Indonesia, 25 tahun, belum menikah datang ke IGD RSCM dengan keadaan syok. Awalnya dinilai sebagai keadaan sepsis namun akhirnya didiagnosis sebagai diabetes insipidus (DI). Didapatkan riwayat berhubungan seksual sebelumnya dan kemudian diketahui menderita kanker serviks stadium IB. Kanker serviks merupakan kanker ketiga tersering pada perempuan di seluruh dunia dan terutama menyerang dewasa muda, dengan konsekuensi individual dan sosial. DI merupakan penyakit yang menyebabkan seringberkemih dan jarang berhubungan dengan kanker serviks. Kejadian bersamaan antara DI dan kanker serviks hanya ditemukan pada  beberapa laporan kasus. Belum dipastikan bahwa kedua kondisi tersebut terjadi bersamaan atau memiliki hubungan sebab-akibat. DI bukan kasus yang sering sehingga mengetahui tanda dan gejala klinis menjadi penting. Di wilayah dunia ketiga dengan keterbatasan dana, pemeriksaan laboratorium dapat disederhanakan dengan memeriksa osmolalitas serum dan urin. Apabila didapatkan kadar yang rendah makadiagnosis DI dapat ditegakkan dengan tatalaksana sederhana seperti pembatasan cairan. Mengenai kanker serviks, trakhelektomi radikal dapat dilakukan dengan pengawasan tiap 3-6 bulan untuk 2 tahun dan tiap 6-12 bulan untuk 3-5 tahun dengan sitologi.Kata Kunci: kanker serviks, diabetes insipidus

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