Clinical characteristics of central diabetes insipidus in taiwanese children
Journal
Journal of the Formosan Medical Association
Journal Volume
112
Journal Issue
10
Pages
616-620
Date Issued
2013
Author(s)
Abstract
Background/Purpose: Data on the clinical features of children with central diabetes insipidus (CDI) are lacking in Taiwan. This study investigated the clinical manifestations and etiology of CDI in Taiwanese children. Methods: From 1983 to 2012, 62 children with permanent diabetes insipidus were enrolled in the study. They were diagnosed at the Department of Pediatrics of National Taiwan University Hospital. Their medical records were thoroughly reviewed and their clinical symptoms and signs, laboratory data, and etiologies were analyzed. Results: The patients' median age at diagnosis was 10 years and the median interval between initial manifestations and diagnosis was 0.5 years. The most common symptoms and signs were polyuria, polydipsia, nocturia, and growth retardation. Most patients had low urine osmolality and elevated plasma osmolality on diagnosis. Absence of a posterior pituitary hyperintense signal and thickening of the pituitary stalk were common findings on magnetic resonance imaging. Approximately 80% of the patients had anterior pituitary hormone deficiency and all patients had growth hormone deficiency. Approximately 60% of patients had intracranial lesions, the most common causes of which were germ cell tumor and Langerhans cell histiocytosis. Two patients were initially believed to have idiopathic CDI but intracranial lesions were detected during the follow-up period. Conclusion: Because a delayed diagnosis of CDI is common in Taiwanese children, a high index of suspicion is important. The underlying etiology of CDI in children may not initially be obvious. Long-term surveillance is therefore necessary, especially for the early detection of evolving treatable intracranial lesions. ? 2013.
SDGs
Other Subjects
adenohypophysis hormone; desmopressin acetate; adolescent; article; brain damage; brain radiography; central diabetes insipidus; child; childhood disease; clinical feature; diabetes insipidus; diabetic patient; female; follow up; germ cell tumor; growth hormone deficiency; growth retardation; headache; human; hypernatremia; hypopituitarism; idiopathic disease; infant; Langerhans cell histiocytosis; major clinical study; male; medical record review; nausea and vomiting; neurohypophysis disease; nocturia; nuclear magnetic resonance imaging; pituitary stalk; plasma osmolality; polydipsia; polyuria; preschool child; pyrexia idiopathica; school child; short stature; symptom assessment; Taiwan; university hospital; urine osmolality; visual disorder; central diabetes insipidus; germ cell tumor; hypopituitarism; Langerhans cell histiocytosis; Adolescent; Brain Neoplasms; Child; Child, Preschool; Diabetes Insipidus, Neurogenic; Female; Growth Hormone; Histiocytosis, Langerhans-Cell; Humans; Hypopituitarism; Infant; Magnetic Resonance Imaging; Male; Neoplasms, Germ Cell and Embryonal; Osmolar Concentration; Pituitary Gland; Pituitary Hormones, Anterior; Taiwan; Urine
Type
journal article