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Hysterical polydipsia (compulsive water drinking) in children
Insights
Hysterical polydipsia presents differently in children, causing severe symptoms like seizures or behavioral changes. Early diagnosis is crucial, especially in children with kidney disease, as it can be life-threatening.
Area of Science:
- Pediatric Nephrology
- Child Psychology
Background:
- Hysterical polydipsia, characterized by excessive thirst and urination, can manifest with diverse clinical presentations in children.
- The condition is often misdiagnosed due to its varied symptoms and the need for specialized physiological evaluation.
Observation:
- Two pediatric cases illustrate the non-uniformity of hysterical polydipsia: one with convulsions and coma in a boy with a single kidney and intrinsic renal disease, and another with abnormal behavior in a girl with normal kidneys.
- Initial evaluations failed to identify hysterical polydipsia in both patients.
Findings:
- Physiological studies confirmed primary polydipsia as the underlying cause for the distinct clinical presentations in both children.
- The differential diagnosis of polydipsia and polyuria was reviewed, highlighting the challenge in recognizing hysterical polydipsia.
Implications:
- Hysterical polydipsia can present with severe, life-threatening symptoms, particularly in children with pre-existing renal conditions.
- Emphasizing the non-uniform presentation is vital for timely and accurate diagnosis in pediatric cases of polydipsia and polyuria.
Abstract:
Two patients had entirely different clinical presentations of hysterical polydipsia: convulsions and coma in a 5-year-old boy with intrinsic renal disease and a single kidney, and abnormal behavior in a 3-year-old girl with normal kidneys. In neither case was the correct diagnosis made on initial evaluation. Physiological studies demonstrated primary polydipsia to be responsible for both clinical presentations. The differential diagnosis of polydipsia and polyuria is reviewed, and the nonuniform presentation of hysterical polydipsia is emphasized. In children with intrinsic renal disease, hysterical polydipsia may be life-threatening.