THE IMPORTANCE OF EARLY DETECTION OF DIABETES INSIPIDUS IN CHILDHOOD

Danijela Jovanović ,
Danijela Jovanović
Contact Danijela Jovanović

Health Center , Leposavić , Serbia

Snezana Marković- Jovanović ,
Snezana Marković- Jovanović

Medical faculty, University of Pristina , Kosovska Mitrovica , Serbia

Teodora Tubić
Teodora Tubić

Medical faculty, University of Novi Sad , Novi Sad , Serbia

Published: 15.01.2025.

Volume 52, Issue 2 (2023)

https://doi.org/10.70949/pramed202502006J

Abstract

Introduction:

Diabetes insipidus (DI) is a disease that occurs due to inappropriate secretion of anti-diuretic hormone from the pituitary, or as a result of disorder in which the level of the kidneys cannot adequately respond to the secretion of this hormone. Also, it is known as central diabetes insipidus. The most common causes are head traumas, tumors of the hypothalamus and pituitary glands, inflammatory processes, histiocytosis, anomalies in the development of brain. It can appear in the form of familial diabetes insipidus or in certain syndromes (Wolfram syndrome). It is characterized by hypotonic polyuria higher than 3l/24h (which persists if even taking liquids stops), then by nocturia and compensatory polydipsia. Enuresis often occurs among children.

Case report:

A boy, aged 11, lives with his mother and brothers. Mother noticed that the boy was urinating frequently in last few months (diuresis 4.6 l/24h, and 3.25 l/24h). After two months, the boy developed double images and severe headaches, vomiting, inability to see, squinting in the right eye and headache in the back of the head. MNR of the endocranium indicates the presence of a tumor formation. The tumor was surgically removed, and the boy started with chemotherapy and radiotherapy. Due to persistent diabetes insipidus, the boy started using desmopressin-acetate - in tablet form. Active substance desmopressin - acts in the same way as the natural hormone vasopressin and regulates the kidney's ability to concentrate urine. The positive effect of taking the drug appeared after three weeks from the start of taking the therapy.

Conclusion:

Central (neurogenic) DI occurs as a result of a relative or absolute deficiency of antidiuretic hormone, which is responsible for the osmolality of body fluids. Based on this case, we want to show the importance of early diagnosis of the disease in order to improve the prognosis and the necessity of careful monitoring of these patients.

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