[The etiology and clinical characteristics of central diabetes insipidus, a retrospective study of 408 cases].
OBJECTIVE
To study the etiology and clinical characteristics of central diabetes insipidus (CDI).


METHODS
The clinical data of 408 cases with CDI treated in Peking Union Medical College Hospital between 1956 and 2000, including 113 cases caused by tumors in sella region, were analyzed retrospectively. Follow-up for three months to 16 years was made to 35 cases of CDI without etiological diagnosis during the first visit.


RESULTS
Most of the cases among children and youngsters fell ill at the age of 8-12 years, while most of the adult cases fell ill at the age of 25-35 years. Idiopathic CDI accounted for 52%. CDI caused by tumor in sella region accounted for about 33% among the child and youngster cases, among which germinoma made up about 65%. CDI caused by tumor in sella region accounted for about 22% in adult cases. Trauma-induced CDI accounted for 11% among adult cases, and about 5% among child and youngster cases. All the CDI cases caused by histiocytosis X, accounting for 3%, were children. A correct diagnosis was made within the period of two years' follow-up among 86% of the cases. For those with brain tumors, the long-term survival rate reached 80% with radiotherapy and/or operation performed without delay.


CONCLUSIONS
GH deficiency accompanied with growth failure is a potential indicator of CDI caused by space occupying lesion in sella region. A sudden alleviation of polydipsia may indicate the dysfunction of adrenal cortex. MRI is the most valuable examination means for tumor in sella region. Regular clinical follow-up with serial brain MRI may discover the covert tumor in sella region in cases diagnosed originally as idiopathic CDI. The cases without a correct diagnosis during the first visit should be followed-up every 3 to 6 months. The prognosis of the patients with CDI without tumor is satisfactory after ADH replacement. Radiotherapy is the most effective treatment of germinoma in sella region.
Gu
F
F
Department of Endocrinology, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
Jin
Z
Z
Zhang
D
D
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D020790:Diabetes Insipidus, Neurogenic / Q000209:etiology* / Q000473:pathology*; D005260:Female; D006728:Hormones / Q000172:deficiency; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D012189:Retrospective Studies; D016019:Survival Analysis
D006728:Hormones