Etiologies of Central Diabetes Insipidus in Thai Children

Santiprabhob, Jeerunda; Likitmaskul, Supawadee; Boonyasiri, Adhiratha; Boonsathorn, Sophida; Buddawong, Theerawat

doi:10.1515/jpem.2005.18.7.653

Cited by 14 publications

(5 citation statements)

References 16 publications

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“…This is likely due to our cohort including patients with recognised predisposing conditions for CDI, rather than restricted to those with an initial presentation of polyuria and polydipsia. In contrast, our cohort reports a higher percentage of patients with craniopharyngioma (32%) than the average 22.5% (15–27%) from the other six paediatric CDI series ( n = 34–147) [ 3 , 4 , 6 – 9 ]. It is noteworthy, that only one of 44 craniopharyngioma patients presented with symptoms of CDI, whereas the rest developed CDI postsurgery.…”

Section: Discussioncontrasting

confidence: 77%

“…Of interest, a larger proportion of patients in our cohort had CDI due to acute CNS insult than most previously published paediatric CDI cohorts [ 3 , 6 – 9 ]. The authors believe this difference is due to our centre being a large regional centre for paediatric neurosurgery and brain trauma.…”

Section: Discussionmentioning

confidence: 96%

“…A few groups have reported causes and long-term outcomes of paediatric CDI at a single institution or combined across multiple institutions [ 3 , 4 , 6 ]. These studies have shown a wide variation in the underlying causes of CDI, including prevalence of idiopathic diabetes insipidus.…”

Section: Introductionmentioning

confidence: 99%

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Central Diabetes Insipidus in Children and Adolescents: Twenty-Six Year Experience from a Single Centre

Korkmaz

Kapoor

Kalitsi

et al. 2022

International Journal of Endocrinology

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Introduction. Paediatric cohorts of central diabetes insipidus (CDI) have shown varying prevalence for different causes of CDI. The objective of this study was to determine the causes of CDI and long-term outcome in children and adolescents from a Tertiary Paediatric Endocrinology unit. Methods. The clinic database was searched to identify patients with CDI managed between 1993 and 2019. Relevant clinical information was collected from patient records. Results. A total of 138 CDI patients, median age 6 years (range <1–18) at presentation, were identified. Principal CDI aetiologies were craniopharyngioma (n = 44), acute central nervous system (CNS) insult (n = 33), germinoma (n = 15), postneurosurgery (indication other than craniopharyngioma and germinoma, n = 20), midline CNS malformation (n = 14), Langerhans cell histiocytosis (n = 5), and familial (n = 2). Idiopathic CDI in this cohort was infrequent (n = 5). Patients with CNS malformations/infections presented with CDI at a younger age compared to patients with CNS tumours p < 0.0001 . Five patients, initially presenting as idiopathic CDI, were subsequently diagnosed with germinoma after a median interval of 3.3 years. All patients with CDI related to craniopharyngioma and nearly all (87%) patients with CDI related to germinoma had concomitant GH, ACTH, and TSH deficiency. The majority of patients who manifested CDI due to acute CNS insult either deceased (30%) or had transient CDI (33.3%). Conclusion. Surgery for craniopharyngioma was the most common underlying aetiology of CDI with ubiquitous occurrence of panhypopituitarism in these patients. Manifestation of CDI in patients with acute CNS insult carries poor prognosis. We affirm that neuroimaging assessment in idiopathic CDI should be continued beyond 3 years from diagnosis as a significant number of patients exhibited progression of infundibular thickening 3 years post-CDI diagnosis.

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Section: Discussioncontrasting

confidence: 77%

Section: Discussionmentioning

confidence: 96%

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Central Diabetes Insipidus in Children and Adolescents: Twenty-Six Year Experience from a Single Centre

Korkmaz

Kapoor

Kalitsi

et al. 2022

International Journal of Endocrinology

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“…Previous studies about pediatric CDI mainly focused on etiology and common features, while our study mainly focused on CDI caused by SSR lesions, and summarized the detailed clinical manifestations, tumor markers, radiology characteristics and histopathology about each etiology, trying to offer evidence for diagnosis and differential diagnosis. Acquired infiltrative disease or tumor including CP, GCT, LCH, pituitary adenoma, lymphoma, astrocytoma, and cavernous hemangioma were all the etiology of CDI reported before (9,(11)(12)(13)(14). In our cohort, the causes of SSR lesions only included GCT, LCH and CP, whose proportions were 74.5, 18.2, and 7.3%, respectively.…”

Section: Discussionmentioning

confidence: 68%

Clinical Characteristics of Pediatric Patients With Sellar and Suprasellar Lesions Who Initially Present With Central Diabetes Insipidus: A Retrospective Study of 55 Cases From a Large Pituitary Center in China

Wang

et al. 2020

Front. Endocrinol.

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Purpose: To increase knowledge for the early differential diagnosis and accurate therapeutic strategies for pediatric patients with sellar or suprasellar region (SSR) lesions who initially present with central diabetes insipidus (CDI).Methods: This is a retrospective review of 55 pediatric patients (≤14 years old) with identified lesions in the SSR who initially presented with CDI at a large pituitary center between 2012 and 2018. The following data were summarized: demographic, clinical, endocrine, and neuroimaging data, intraoperative findings, histopathological findings, treatments, and prognosis.Results: In our group, the etiologies of the SSR lesions included germ cell tumors (GCTs, 74.5%), Langerhans cell histiocytosis (LCH, 18.2%), and craniopharyngioma (CP, 7.3%). Almost all patients (50/55, 90.9%) showed anterior pituitary dysfunction [multiple axes dysfunction (38), and isolated axis dysfunction (14)], while the GH/IGF-I axis was the most affected. Most GCT patients presented with various clinical manifestations besides CDI and had elevated β-HCG, whereas LCH and CP patients mostly presented few non-specific symptoms besides CDI and most had normal level tumor markers. Sellar MRI demonstrated that posterior pituitary bright spot disappearance occurred in all patients, and pituitary stalk thickening was observed in 96.7% of patients. Treatment varied due to the different etiologies of the SSR lesions. After follow-up for 35.4 ± 20.2 months, the proportions of patients who needed AVP (arginine vasopressin) for GCT, LCH, and CP were 86.5, 100, and 75%, respectively, and the proportions of patients who needed HRT were 89.2, 50, and 75%, respectively. Ji et al. Pediatric SSR Lesions With CDIConclusion: For pediatric SSR lesions that first manifest as CDI, we should comprehensively consider clinical characteristics and imaging features to aid in their early differential diagnosis. Tumor markers and surgical histopathology are also great complements for the differential diagnosis. Additionally, various treatment strategies should be adopted according to different causes to improve the child's prognosis and quality of life.

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“…1 Las malformaciones cerebrales representan una de las principales causas [2][3][4][5][6][7] y, entre ellas, la hidranencefalia, caracterizada por ausencia de gran parte del tejido supratentorial, puede asociarse a una DIC. 4 La desmopresina, una droga análoga sintética de la vasopresina, es el fármaco de elección para tratar la DIC. Se puede administrar por vía oral, nasal, parenteral y sublingual.…”

Section: Introductionunclassified

Tratamiento con desmopresina sublingual en dos lactantes con hidranencefalia y diabetes insípida central

2018

Arch Argent Pediatr

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Presentación de casos clínicos RESUMENLa diabetes insípida central es una patología infrecuente en pediatría ocasionada por un déficit de vasopresina. Sus manifestaciones clínicas principales son poliuria y polidipsia. Las malformaciones cerebrales son una de las principales causas. La desmopresina es la droga sintética de elección para el tratamiento. Una de las vías de administración es la sublingual y su uso en lactantes es muy limitado. Se describe a dos lactantes con hidranencefalia y diabetes insípida central que fueron tratados satisfactoriamente con desmopresina sublingual. Palabras clave: diabetes insípida central, desmopresina, hidranencefalia, malformaciones del sistema nervioso. ABSTRACTCentral diabetes insipidus is a rare disease in children caused by a deficiency of vasopressin. Its main clinical manifestations are polyuria and polydipsia. Brain malformations are one of the main causes. Desmopressin is the synthetic drug of choice for the treatment. One of the routes of administration is sublingual and its use in infants is very limited. We describe two infants with central diabetes insipidus and hydranencephaly who were successfully treated with sublingual desmopressin.

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Etiologies of Central Diabetes Insipidus in Thai Children

Cited by 14 publications

References 16 publications

Central Diabetes Insipidus in Children and Adolescents: Twenty-Six Year Experience from a Single Centre

Central Diabetes Insipidus in Children and Adolescents: Twenty-Six Year Experience from a Single Centre

Clinical Characteristics of Pediatric Patients With Sellar and Suprasellar Lesions Who Initially Present With Central Diabetes Insipidus: A Retrospective Study of 55 Cases From a Large Pituitary Center in China

Tratamiento con desmopresina sublingual en dos lactantes con hidranencefalia y diabetes insípida central

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