Prenatal presentation of transient central diabetes insipidus
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Tanoj Gopalan Kollamparambil & Pammi Venkatesh Mohan & Kavitha Gunasuntharam & Bhavdeep Rameshchandra Jani & David Gerard Penman
- چاپ و سال / کشور: 2011
Description
Introduction Nephrogenic diabetes insipidus (DI) in the foetus has been described as a rare presentation of severe polyhydramnios. Discussion We report a case of foetal central DI, characterised by severe polyhydramnios. Significant polyuria was noted at birth. Serum AVP level was un-measurable (<0.5 pg/ml). A dramatic response to intravenous dDAVP (desmopressin) was noted confirming central DI. Further investigations did not reveal a recognised cause for central or nephrogenic DI. The infant thrived well on a small dose of oral desmopressin until the age of 12 months. At 13 months, a water deprivation test revealed a normal ability to concentrate urine without desmopressin, and subsequently, the infant has thrived without further treatment. The transient nature of the central DI remains obscure but could be explained by a maturational delay in the tissues involved in AVP synthesis or release, during intrauterine life and infancy. Conclusion Both nephrogenic and central DI should be considered as a cause of severe polyhydramnios. This may help to guide prompt intensive management and investigation, with attention to vascular access, central venous pressure, urine output monitoring and replacement.
Eur J Pediatr (2011) 170:653–656 DOI 10.1007/s00431-010-1340-2Received: 27 July 2010 / Accepted: 20 October 2010 / Published online: 12 November 2010
