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Diabetes Insipidus in Pediatrics Introduction: Diabetes insipidus (DI) is a syndrome characterized by polyuria and polydipsia secondary to a decreased secretion or action of the antidiuretic hormone (ADH). An early diagnosis is essential. Diagnosis is made by measuring plasma and urinary osmolarity and their changes under water deprivation and after DDAVP administration. Objective: To describe the clinical, radiological characteristics as well as the initial treatment of eight children with DI, 3 of them nephrogenic DI (DIN) and 5 with central DI. Methods: A Retrospective, descriptive study in DI patients under control at the Catholic University of Chile and Sotero del Rio Hospital between 1998-2008 is presented. Clinical files were evaluated collecting clinical, epidemiologic, biochemical and image data. Serum (Sosm) and urinary osmolarity (Uosm) were registered. DI was diagnosed with a Sosm > 300 and Usm < 600 mOsm/L. Central DI was defined as the inability to reach a Uosm > 600 or a 50%-increase after DDAVP treatment. Otherwise DI was classified as DIN. Results: Eight patients (5 males) were studied. Chief complaints were polydipsia/polyuria (5/8), hyperthermia (2/8), and failure to grow (1/8). MRI showed endocraneal lesion in all patients with Central DI. All of these utilized oral or inhalatory DDAVP treatment. Patients with Nephrogenic DI were trated with Hydrochlrothiazide. Conclusion: Polydipsia, polyuria, hyperthermia with hypernatremia are suggestive of DI in the first year of life. Water deprivation test is diagnostic in differentiating Central and Nephrogenic DI. MRI is an essential diagnostic tool in CDI. Manegement should be multidisciplinary, including a pediatician, nephrologist, endocrinologist and nutricionist.

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Adrenal Function in Patients with Acute Bronchial Obstruction Treated with Systemic Corticosteroids: A Preliminary Report Introduction: Systemic corticosteroids are widely used in patients with acute bronchial obstruction (ABO). It has been recommended that such treatment last a maximum of 5 days to avoid adverse effects. Suppression of the adrenal axis under these conditions among children has not been evaluated. Objective: Assessment of the hypothalamic pituitary adrenal axis (HHS) function after use of systemic steriods in children after a 5-7 day use of corticoids, utilizing the micro ACTH test. Method: Prospective observational study conducted in the Department of Pediatrics, Hospital Clínico Universidad Católica de Chile. ACTH test used with microdosis (1 mcg/1.73 m 2). A normal response was determined if cortisol post-ACTH > 20 mcg/dL. Results: 7 patients were recruited, median age was 4 years 4 months (range 4 months to 8 years). The test was perfomed within an average of 72 hours after discontinuation of prednisone. All patients had normal basal cortisol values, with an average value of 6.5 mcg/dl, range 1 to 9 mcg/dl. The ACTH test yielded a response of cortisol levels with an average value of 13.6 mcg/dL and a range of 3.7 to 20 mcg/dL. Five of the 7 patients presented an abnormal response. Conclusions: Our results suggest that the adrenal response may be reduced in children who have been treated with systemic steroids for ABO even if managed during short periods of time.