Diabetes insipidus as an early clinical manifestation of pineal tumor

Diniz, José Silvério Santos; Oliveira, Eduardo A.; Servilha, Marina M.

doi:10.2223/jped.78

Cited by 2 publications

(1 citation statement)

References 16 publications

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“…1 Many studies show that DI may be the first symptom of a brain tumor, metastatic lesions, or granulomas due to the infiltration of the hypothalamic-pituitary area. [19][20][21] An early systematic MRI assessment may be crucial to indicate the etiology of CDI. 16,17 This is why the close clinical, laboratory, and neuroradiological follow-up of patients with CDI may detect pathologic processes, especially intracranial tumors, at an early stage.…”

Section: Introductionmentioning

confidence: 99%

Central Diabetes Insipidus in Children as a Diagnostic Challenge

Dyrka,

Dzialach,

Niedziela

et al. 2023

Clin Pediatr (Phila)

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Central diabetes insipidus (CDI) is a disorder in the pediatric population resulting from antidiuretic hormone deficiency. The excessive production of dilute urine characterizes it and manifests with polyuria, nocturia, and polydipsia. The diagnostics of CDI is often challenging, especially concerning the underlying condition of the disease. This article highlights the diverse clinical presentation of children with CDI and diagnostic difficulties among patients with polyuria and polydipsia. The article also reviews the etiology, symptoms, diagnostic workup, and management of CDI. We present 4 pediatric patients (aged 3-13.5 years) diagnosed with CDI of different etiology: 1 due to septo-optic dysplasia/optic nerve hypoplasia and 3 due to acquired processes such as Langerhans cell histiocytosis and germ cell tumor in 2 patients. Central diabetes insipidus was the first manifestation of a tumor or granuloma in all presented patients with acquired pathology. The patients sometimes need long-term follow-up to establish the proper final diagnosis.

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Section: Introductionmentioning

confidence: 99%

Central Diabetes Insipidus in Children as a Diagnostic Challenge

Dyrka,

Dzialach,

Niedziela

et al. 2023

Clin Pediatr (Phila)

View full text Add to dashboard Cite

show abstract

Central diabetes insipidus in children as a diagnostic challenge – analysis of different clinical pictures and review of the literature

Dyrka

Dzialach

Niedziela

et al. 2022

Preprint

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Background: Central diabetes insipidus (CDI) is a rare disorder in the pediatric population resulting from antidiuretic hormone (ADH) deficiency and caused by several underlying conditions. It is characterized by the excessive production of dilute urine and manifests with polyuria, nocturia, and polydipsia. An appropriate investigation requires a detailed medical history, physical examination, biochemical evaluation (including fluid deprivation test, potentially followed by desmopressin test), and neuroimaging. The diagnosis of CDI is often challenging, especially the underlying condition. The patients sometimes need long-term follow-up to establish the proper final diagnosis. This paper highlights the diverse clinical presentation of children with CDI, diagnostic difficulties among patients presenting with polyuria and polydipsia, and the need for an individual approach in each case. The article also reviews the etiology, symptoms, diagnostic work-up, and management of CDI. Case Presentation: We present four pediatric patients (aged 3-13.5 years) diagnosed with CDI of different etiology; one due to congenital anomaly - septo-optic-dysplasia (SOD) and three due to acquired processes such as Langerhans cell histiocytosis (LCH) and germ cell tumor (GCT) in two patients. Conclusions: CDI was the first manifestation of a tumor or granuloma in all presented patients with acquired pathology. Due to the presented course of illness, it may be concluded, the coexistence of other pituitary hormone deficiencies at initially recognized idiopathic CDI should suggest a more complicated diagnostically problem. Case with a delayed diagnosis with SOD at the age of 13.5 years and case with GCT, where from the CDI diagnosis to the occurrence of pathological change in pituitary stalk 1.5 years have passed, highlight the need for a high clinical suspicion in patients with CDI.

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Diabetes insipidus as an early clinical manifestation of pineal tumor

Cited by 2 publications

References 16 publications

Central Diabetes Insipidus in Children as a Diagnostic Challenge

Central Diabetes Insipidus in Children as a Diagnostic Challenge

Central diabetes insipidus in children as a diagnostic challenge – analysis of different clinical pictures and review of the literature

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