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INCIDENCE OF CENTRAL DIABETES INSIPIDUS IN CHILDREN PRESENTING WITH POLYDIPSIA AND POLYURIA

Nadine G Haddad, Zeina M Nabhan, Erica A Eugster

    Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
    |August 20, 2016
    PubMed

    Insights

    Central diabetes insipidus (CDI) is uncommon in children with polydipsia and polyuria. Older age, preference for cold drinks, and higher baseline serum sodium levels during a water deprivation test (WDT) suggest potential pathology.

    Area of Science:

    • Pediatric Endocrinology
    • Nephrology
    • Pediatric Urology

    Background:

    • Polydipsia and polyuria are common referral reasons to pediatric endocrine clinics.
    • In cases without hyperglycemia, diabetes insipidus (DI) is a key differential diagnosis.
    • Central DI (CDI) involves insufficient antidiuretic hormone production.

    Purpose of the Study:

    • To determine the prevalence of central DI (CDI) in children evaluated for polydipsia and polyuria.
    • To identify predictive features for CDI in this pediatric cohort.

    Main Methods:

    • A retrospective chart review was conducted over a 5-year period.
    • The study included children presenting with polydipsia and polyuria to an endocrine clinic.
    • Diagnosis of CDI was confirmed by abnormal water deprivation test (WDT) results.

    Main Results:

    • CDI was diagnosed in 8 out of 41 (20%) children.
    • MRI findings, often pituitary stalk thickening, were common in CDI patients.
    • Children with CDI were older and exhibited increased cold beverage intake and unusual water-seeking behaviors.

    Conclusions:

    • The incidence of CDI in children with polydipsia and polyuria is relatively low.
    • Predictive factors for CDI include older age, preference for cold beverages, and elevated baseline serum sodium and osmolality on WDT.
    Abstract

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