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Clinical Study of Diabetes Insipidus.

Journal of the Korean Pediatric Society 1987;30(8):882-890.
Published online August 31, 1987.
Clinical Study of Diabetes Insipidus.
Jung Bae Lee, Duk Hi Kim
Department of Pediatrics, College of Medicine, Yonsei University, Seoul, Korea
소아 요붕증의 임상적 고찰
이정배, 김덕희
연세대학교의과대학 소아과학교실
Abstract
From Aug. 1979 to June 1986 we reviewed 27 patients with diabetes insipidus to observe the clinical features, laboratory findings and treatment of diabetes insipidus. The results were as follows: 1) Central diabetes insipidus were 22 cases (81.5%) and nephrogenic diabetes insipidus were 5 cases (18.5%). Etiologic factors in the central diabetes insipidus included idiopathic (54.6%), craniopharyn- gioma (18.2%), germinoma (13.6%), post-encephalitis (9.1%) and Histiocytosis X (4.5%). 2) In cases of central diabetes insipidus, the male to female ratio was 1:1.4 and the peak age was 5-10 years with mean age of 7.9 years. In cases of nephrogenic diabetes insipidus, the male to female ratio was 4: 1 and the peak age was below 5 years with mean age of 3.5 years. 3) The major presenting symptoms were polydipsia, polyuria, growth retardation, nocturia and headache. 4) In cases of central diabetes insipidus, the urine osmolarity with dehydration was 193.11 mosm/kg and after vasopressin injection the urine osmolartiy was 510.11 mosm/kg. On the contrary, in cases of nephrogenic diabetes insipidus the urine osmolarity with dehydration was 124.60 mosm/kg and after vasopressin injection the urine osmolarity was 91.60 mosm/kg. 5) Other hormones deficiencies were found in 8 cases among 22 cases of central diabetes insipidus. Growth hormone deficiency were present in 8 cases, cortisol deficiency in 6 cases, thyroid hormone deficiency in 5 cases and estradiol deficiency in 1 case. 6) In cases of central diabetes insipidus treated with diabenase, pitressin and DDAVP, clinical improvement was observed and urine specific gravity and osmolarity were increased. In cases of nephrogenic diabetes insipidus treated with hydrochiorthiazide or indomethacine and hydrochlorthi- azide, urine specific gravity was not increased.
Key Words: Central diabetes insipidus, Nephrogenic diabetes insipidus


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