The patient didn’t respond to water restriction and dDAVP test.
Diagnosis of Nephrogenic DI (Mostly related to Lithium +/- Multiple Myeloma) was made.
Treatment started with Fluid deficit correction with careful monitoring of serum sodium, Bendroflumethiazide 2.5 mg BD and Ibuprofen 400 mg TDS with good sustained response. GCS continued to improve.
Three days later Ibuprofen with stopped and 7 days later Bendroflumethiazide was reduced to OD.
