Acquired central diabetes insipidus in children: A 12 year Brisbane experience

Al-Agha, A., Thomsett, M., Ratcliffe, J., Cotterill, A. M. and Batch, J. A. (2001) Acquired central diabetes insipidus in children: A 12 year Brisbane experience. Journal of Paediatrics and Child Health, 37 2: 172-175.


Author Al-Agha, A.
Thomsett, M.
Ratcliffe, J.
Cotterill, A. M.
Batch, J. A.
Title Acquired central diabetes insipidus in children: A 12 year Brisbane experience
Journal name Journal of Paediatrics and Child Health   Check publisher's open access policy
Publication date 2001
Sub-type Article
DOI 10.1046/j.1440-1754.2001.00640.x
Volume number 37
Issue number 2
ISSN 1034-4810
Start page 172
End page 175
Total pages 4
Editor Dr J. M. Court
Place of publication Melbourne
Publisher Blackwell Science Asia
Collection year 2001
Language eng
Subject C1
321004 Endocrinology
730105 Endocrine organs and diseases (incl. diabetes)
Abstract Objective: To study the clinical, endocrine and radiological features and progress of children presenting with acquired diabetes insipidus (CDI). Methodology: Chart review of children presenting because of CDI to Brisbane paediatric endocrine clinics between 1987 and 1999. Results: Thirty-nine children (female/male ratio 21/18) aged 0.1-15.4 years (mean age 6.7 years) were identified. Aetiologies were head trauma or familial in eight cases (20.5%) each, central nervous system (CNS) tumours in five cases (12.8%), CNS malformations in four cases (10.2%), histiocytosis in three cases (7%) and hypoxia and infection in two cases (5.1%) each. Seven cases (17.9%) remain undiagnosed. Of the 32 (82%) cases with isolated anti-diuretic hormone deficiency at presentation, 24 cases (61.5%) experienced no further endocrine deficit. Additional endocrine deficits occurred mainly in the tumour or undiagnosed groups. On follow-up brain magnetic resonance imaging (MRI) scans in the seven undiagnosed cases, six patients bad mild or no change and one patient had marked improvement of MRI findings. These changes occurred 10-48 months (mean 18 months) after presentation. Conclusions: Children without an aetiological diagnosis for the uncommon condition of acquired CDI require careful follow-up. More intensive investigation at presentation (e.g. estimation of cerebrospinal fluid human chorionic gonadotrophin) promises to lessen the number of such cases. Pituitary stalk biopsies should be reserved for those patients with progressive MRI changes. If these changes do not occur early, our experience suggests that follow-up MRI scans may need to be performed only yearly.
Keyword Pediatrics
Acquired
Central Diabetes Insipidus
Children
Q-Index Code C1

Document type: Journal Article
Sub-type: Article
Collection: School of Medicine Publications
 
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