Central diabetes insipidus as a complication of neonatal pathology: Report of three cases

Abstract

Nrc~nrrftrl lritrri 511 11 Coie Urirr triirl Perlrtiri i i Eiidoc riiie Uiirt, h i \trtuto tfcr Cr r a i~p~ S6o Pnulo Unrwrsrt~ { ( h0Ol Of Iblt'dl( IIIC'. s ( J PAbstract Three patient\. I 1. 17 and 41 days old with mrious degrees of central nervous system (CNS) lesions dz\ eloped central diabetes insipidus as ii complication of hypothalamic damage. Two of the children had congenital CNS malfomiations including meningomyelocele, hydrocephalus. and prosencephaly, while the third child presented Sfr-~,~el,toc.oc.c.ir.r c c g d m i o r meningitis. complicated with CNS hemorrhage and h! pertensive dilatation of the lateral ventricles. All of them fulfilled the criteria for central diabetes insipidus, reaching high le\els of serum sodium and osmolality. along with hypotonic urine. The responses to intran ~irzininc-~a.lopressin were prompt. nornialiiing the serum levels of sodium and increasing urinary osmolality, allou ing ii better metabolic balance. avoiding continuing damage to the already compromised CNS. The neonatologist must he aware of the pos4bility of this kind o f complication even in a normal child with CNS infection. Imaging studies showing hemorrhage in the region of the posterior hypothalanius must be a sign that this type of complication is able to occur. Key words antidiuretic hormone. diabete4 insipidus. hydrocephalus. meningitis. neonate.

Central diabetes insipidus: alert for dehydration in very low birth weight infants during the neonatal period. A case report

“…Possible causes that may be considered include: asphyxia, severe infections, congenital infections, peri or intraventricular hemorrhage and CNS abnormalities. 7,8 Although the etiology and treatment of CDI has been described previously in several case series among children, it remains a relatively rare disorder in the neonatal population, and specifically in VLBW newborns. The importance of this report is to alert neonatologists regarding this possible diagnosis when they are faced with cases of dehydration and hypernatremia in the neonatal period, given that this is not among the most common causes.…”

“…Possible causes that may be considered include: asphyxia, severe infections, congenital infections, peri or intraventricular hemorrhage and CNS abnormalities. 7 , 8 …”

Hypernatraemia: diagnosis and management

“…It is uncommon in infancy and usually secondary to acquired disease of or damage to the anterior hypothalamus, 4 although a very rare, usually dominantly inherited, genetic form has been described. 5 In older children it may be caused by Langerhans cell histiocytosis, hypothalamic or pituitary tumours such as craniopharyngioma, damage caused by encephalitis or meningitis, or infarction of the pituitary stalk (Sheehan's syndrome).…”