Evaluation of the etiological and clinical characteristics of pediatric central diabetes insipidus
Author:
Gasimova Elnare1, Berberoğlu Merih2, Özsu Elif2ORCID, Aycan Zehra2, Uyanık Rukiye2, Bilici Esra2, Ceran Ayşegül2, Şiklar Zeynep2
Affiliation:
1. Department of Pediatrics Balkiraz Mahallesi , Ankara Univesity School of Medicine , Mamak , Ankara , Turkey 2. Department of Pediatric Endocrinology and Diabetes , Ankara Univesity School of Medicine , Mamak , Ankara , Turkey
Abstract
Abstract
Objectives
Central diabetes insipidus (CDI) is a rare but important disease of varying etiology that poses challenges in diagnosis and follow-up. Identifying diagnostic difficulties in patients with CDI will help ensure an optimal approach to their management and follow-up. This study aimed to characterize the clinical and etiological characteristics of CDI in pediatric patients.
Methods
We analyzed the admission and follow-up data of CDI patients aged 0–18 years who were followed in our center between 2010 and 2019.
Results
The study included 56 patients with a mean age at diagnosis of 7.92 ± 5.11 years and symptom duration of 8.65 ± 21.3 months. The patients were grouped by etiology into those with organic causes, such as structural anomalies, tumors, and trauma (group 1, n=41) and other causes (group 2, n=15). The prevalence of idiopathic CDI was 16%. At least one pituitary hormone deficiency was detected in 60.7%, the most common being thyroid stimulating hormone deficiency. Patients in group 1 had a higher mean age at diagnosis, shorter symptom duration, and higher frequency of other pituitary hormone deficiencies compared to group 2. Additionally, germinoma was detected 1 year subsequent to normal MRI findings at diagnosis and another patient was diagnosed with Langerhans cell histiocytosis (LCH) 5 years after diagnosis. All patients responded well to replacement therapies, but two patients with germinoma died during follow-up.
Conclusions
In the pediatric age group, intracranial organic pathologies are an important etiology of CDI, and despite a short symptomatic period, determining the cause may be challenging and prolonged. Patients presenting at a young age with a long history of symptoms and no other pituitary hormone deficiency are unlikely to have organic CDI. However, organic causes such as LCH should be evaluated at all ages. Patients with idiopathic disease are candidates for further etiological studies, and repeated cranial imaging is important during follow-up.
Publisher
Walter de Gruyter GmbH
Subject
Endocrinology,Endocrinology, Diabetes and Metabolism,Pediatrics, Perinatology and Child Health
Reference23 articles.
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