title: Acquired central diabetes insipidus in children: a 12-year Brisbane experience.
abstract: OBJECTIVE
  To study the clinical, endocrine and radiological features and progress of children presenting with acquired diabetes insipidus (CDI).
  
  
  METHODS
  Chart review of children presenting because of CDI to Brisbane paediatric endocrine clinics between 1987 and 1999.
  
  
  RESULTS
  Thirty-nine children (female/male ratio 21/18) aged 0.1-15.4 years (mean age 6.7 years) were identified. Aetiologies were head trauma or familial in eight cases (20.5%) each, central nervous system (CNS) tumours in five cases (12.8%), CNS malformations in four cases (10.2%), histiocytosis in three cases (7%) and hypoxia and infection in two cases (5.1%) each. Seven cases (17.9%) remain undiagnosed. Of the 32 (82%) cases with isolated anti-diuretic hormone deficiency at presentation, 24 cases (61.5%) experienced no further endocrine deficit. Additional endocrine deficits occurred mainly in the tumour or undiagnosed groups. On follow-up brain magnetic resonance imaging (MRI) scans in the seven undiagnosed cases, six patients had mild or no change and one patient had marked improvement of MRI findings. These changes occurred 10-48 months (mean 18 months) after presentation.
  
  
  CONCLUSIONS
  Children without an aetiological diagnosis for the uncommon condition of acquired CDI require careful follow-up. More intensive investigation at presentation (e.g. estimation of cerebrospinal fluid human chorionic gonadotrophin) promises to lessen the number of such cases. Pituitary stalk biopsies should be reserved for those patients with progressive MRI changes. If these changes do not occur early, our experience suggests that follow-up MRI scans may need to be performed only yearly.
authors.affiliation: Department of Endocrinology and Diabetes, Royal Children's Hospital Brisbane, Queensland, Australia. abdulmoa@nch.edu.au
authors.forename: A E
authors.initials: AE
authors.lastname: Al-Agha
authors.forename: M J
authors.initials: MJ
authors.lastname: Thomsett
authors.forename: J F
authors.initials: JF
authors.lastname: Ratcliffe
authors.forename: A M
authors.initials: AM
authors.lastname: Cotterill
authors.forename: J A
authors.initials: JA
authors.lastname: Batch
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D020790:Diabetes Insipidus, Neurogenic / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D017063:Outcome Assessment, Health Care; D011793:Queensland / Q000453:epidemiology