Diabetes insipidus and polydipsia in a patient with Asperger's disorder and an empty sella: a case report.

Doctors wrote up one adult man who had Asperger’s, drank gallons of water each day, and wet the bed nightly.

Brain scans showed an empty sella (the spot where the pituitary gland sits looked hollow).

Lab tests proved diabetes insipidus: his body could not hold water, so he kept urinating and drinking.

Treating the hormone shortage with desmopressin stopped the thirst and bed-wetting cold.

The team says the empty sella may have squeezed the pituitary enough to cause the problem.

Griffith et al. (2012) also autopsied an Asperger man, but found only a big brain and no empty sella. The two case studies sit side-by-side: one shows a hormone fault, the other shows plain brain growth.

Lugnegård et al. (2011) looked at 54 Asperger adults and found lots of depression and anxiety, yet never checked for diabetes insipidus. Our case hints that some “psychiatric” thirst or bed-wetting might really be a hormone issue.

Mammarella et al. (2022) and Matson et al. (2004) each link autism to rare body conditions (48,XXYY and CMV). Our paper adds empty sella to that same rare list.

If your client with Asperger’s drinks non-stop or wakes up soaked, do not shrug it off as a quirky habit. Ask for a urine and blood osmolality test and request a brain MRI. One shot of desmopressin each night could end the problem and spare years of wet sheets and shame.