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Etiologies of central diabetes insipidus in children
L C Wang1, M E Cohen, P K Duffner
1Department of Neurology, State University of New York at Buffalo.
Insights
Central diabetes insipidus in children is most commonly caused by brain tumors. Modern neuroimaging has significantly improved the diagnosis of this condition and its underlying causes.
Area of Science:
- Pediatric Endocrinology
- Pediatric Neurology
- Neuroimaging
Background:
- The last comprehensive review of pediatric central diabetes insipidus (CDI) etiologies predates modern neuroimaging.
- Understanding the causes of CDI is crucial for timely diagnosis and management in children.
Purpose of the Study:
- To retrospectively analyze the etiologies of central diabetes insipidus in pediatric patients.
- To evaluate the impact of advancements in neuroimaging on identifying structural lesions causing CDI.
Main Methods:
- Retrospective review of medical records of pediatric patients diagnosed with CDI between 1979 and 1992.
- Data collection included patient demographics, identified etiologies, and associated endocrinopathies.
Main Results:
- Brain tumors were the most frequent cause (19/35 patients), followed by cerebral malformations (7/35).
- Most patients (31/35) presented with additional endocrinopathies.
- Idiopathic cases accounted for 5/35 patients.
Conclusions:
- Brain tumors and their treatment remain the leading cause of CDI in children.
- Modern neuroimaging techniques like cranial MRI enhance the identification of structural causes of CDI.
- Further research is needed to understand the pathophysiology and improve diagnostic accuracy for idiopathic cases.
Abstract:
The last major review of the etiologies of central diabetes insipidus in children was performed a quarter century ago, prior to the development of modern neuroimaging techniques. We retrospectively reviewed the records of children with central diabetes insipidus identified at Children's Hospital of Buffalo from 1979 to 1992. Of the 35 patients identified, 27 were males and 8 were females. Their ages ranged from 3 weeks to 20 years. Nineteen children had brain tumors, 7 had cerebral malformations, 3 had central nervous system infections, 1 had traumatic brain injury, and 5 were considered idiopathic. Patients with brain death were excluded from the review. Thirty-one of 35 patients developed diabetes insipidus in conjunction with other endocrinopathies. Brain tumor and its treatment account for the most common cause. Cranial magnetic resonance imaging has improved the identification of structural lesions and the understanding of the pathophysiology of central diabetes insipidus.