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Compulsive water drinking in infants and young children
Insights
This study details managing five infants with compulsive water drinking, a condition causing excessive thirst and urination. Gradual fluid restriction successfully resolved symptoms, normalizing urine concentration and preventing relapse.
Area of Science:
- Pediatrics
- Endocrinology
- Nephrology
Background:
- Compulsive water drinking, or psychogenic polydipsia, can manifest in infants.
- This condition presents with polyuria and polydipsia, often leading to electrolyte imbalances.
Observation:
- Five infants (3 female, 2 male; 6-20 months) presented with asymptomatic compulsive water drinking.
- Patients exhibited polyuria/polydipsia, low urine osmolalities (39-112 mOsm/L), high fluid intake (3.5-5 L/day), and elevated urine output (11-14 mL/kg/hr).
Findings:
- A gradual fluid weaning process led to significant clinical improvement.
- Following fluid intake normalization, urine osmolalities increased to 210-500 mOsm/L at 4 weeks and 630-800 mOsm/L at 8 weeks.
- No relapses occurred during 6- to 24-month follow-up.
Implications:
- Pediatricians must recognize compulsive water drinking as a potentially serious, albeit not rare, pediatric habit.
- Early identification and management through fluid restriction are crucial for favorable outcomes.
- This condition highlights the importance of monitoring fluid intake and urine concentration in infants with unexplained polyuria/polydipsia.
Abstract:
The management and follow-up of five patients with asymptomatic compulsive water drinking is described. Three out of the five patients were female and two were male. The age range was 6 to 20 months. All the patients presented with polyuria or polydipsia and urine osmolalities of 39 to 112 mOsm/L. The daily fluid intake ranged from 3.5 to 5 L, and the urine output was 11 to 14 mL/kg/hr. Significant improvement was noticed after a gradual weaning process. As fluid intake returned to normal, urine osmolalities reached values between 210 and 500 mOsm/L after 4 weeks, and between 630 and 800 mOsm/L after 8 weeks. No relapse was noted during the 6- to 24-month follow-up period. Pediatricians should be aware of this potentially dangerous--yet not uncommon--habit.