Evaluation of the etiological and clinical characteristics of pediatric central diabetes insipidus
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Elnare Gasimova
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Zehra Aycan
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.
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Research funding: None declared.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Informed consent was obtained from all individuals included in this study.
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Ethical approval: The local Institutional Review Board deemed the study exempt from review.
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© 2022 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Review Article
- Effects of vitamin D supplementation on glycemic control of children and adolescents with type 1 diabetes mellitus: a systematic review
- Original Articles
- A preliminary study on the relationship between environmental endocrine disruptors and precocious puberty in girls
- Tissue concentration of aldosterone in fetal adrenals of intrauterine death cases
- Complications of orthopedic treatment in patients diagnosed with X-linked hypophosphatemic rickets
- Comparison of insulin sensitivity indices for detection of double diabetes in Indian adolescents with type 1 diabetes
- Evaluation of the growth and nutritional status of preschool children: a pilot study in the cold area of China
- Arterial hypertension is associated with an increased risk of metabolic complications in pediatric patient with obesity
- From pregnancy to breastfeeding: adequate maternal body mass index is essential to prevent a high body mass index in your children
- Screening of non-syndromic early-onset child and adolescent obese patients in terms of LEP, LEPR, MC4R and POMC gene variants by next-generation sequencing
- The association between vitamin B12, folate, homocysteine levels, and carotid intima-media thickness in children with obesity: a cross-sectional study
- Comprehensive assessment of cardiovascular disease risk in children with short stature due to isolated growth hormone deficiency: a case-control study
- Visceral adiposity is related to insulin sensitivity and inflammation in adolescents with obesity and mild sleep disordered breathing
- Recurrent hypoglycemic seizure as a presenting symptom of post-TBI hypopituitarism in children: a case report, review and proposed protocol
- Evaluation of the etiological and clinical characteristics of pediatric central diabetes insipidus
- Case Reports
- Clinical and radiologic evaluation of a Turkish family with hypochondroplasia and a rare FGFR3 variant
- Rituximab therapy in ROHHAD(NET) syndrome
- Ectopic parathyroid hormone as a rare aetiology of hypercalcemia with rhabdomyosarcoma: a new treatment strategy with zoledronic acid and Denosumab
- A 2-bp deletion mutation in SMPD1 gene leading to lysosomal acid sphingomyelinase deficiency in a Chinese consanguineous pedigree
Articles in the same Issue
- Frontmatter
- Review Article
- Effects of vitamin D supplementation on glycemic control of children and adolescents with type 1 diabetes mellitus: a systematic review
- Original Articles
- A preliminary study on the relationship between environmental endocrine disruptors and precocious puberty in girls
- Tissue concentration of aldosterone in fetal adrenals of intrauterine death cases
- Complications of orthopedic treatment in patients diagnosed with X-linked hypophosphatemic rickets
- Comparison of insulin sensitivity indices for detection of double diabetes in Indian adolescents with type 1 diabetes
- Evaluation of the growth and nutritional status of preschool children: a pilot study in the cold area of China
- Arterial hypertension is associated with an increased risk of metabolic complications in pediatric patient with obesity
- From pregnancy to breastfeeding: adequate maternal body mass index is essential to prevent a high body mass index in your children
- Screening of non-syndromic early-onset child and adolescent obese patients in terms of LEP, LEPR, MC4R and POMC gene variants by next-generation sequencing
- The association between vitamin B12, folate, homocysteine levels, and carotid intima-media thickness in children with obesity: a cross-sectional study
- Comprehensive assessment of cardiovascular disease risk in children with short stature due to isolated growth hormone deficiency: a case-control study
- Visceral adiposity is related to insulin sensitivity and inflammation in adolescents with obesity and mild sleep disordered breathing
- Recurrent hypoglycemic seizure as a presenting symptom of post-TBI hypopituitarism in children: a case report, review and proposed protocol
- Evaluation of the etiological and clinical characteristics of pediatric central diabetes insipidus
- Case Reports
- Clinical and radiologic evaluation of a Turkish family with hypochondroplasia and a rare FGFR3 variant
- Rituximab therapy in ROHHAD(NET) syndrome
- Ectopic parathyroid hormone as a rare aetiology of hypercalcemia with rhabdomyosarcoma: a new treatment strategy with zoledronic acid and Denosumab
- A 2-bp deletion mutation in SMPD1 gene leading to lysosomal acid sphingomyelinase deficiency in a Chinese consanguineous pedigree
