title: Prenatal presentation of transient central diabetes insipidus.
abstract: BACKGROUND
  Nephrogenic diabetes insipidus (DI) in the foetus has been described as a rare presentation of severe polyhydramnios.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Royal Gwent Hospital, Newport, Gwent NB20 2UB, UK.
authors.forename: Tanoj Gopalan
authors.initials: TG
authors.lastname: Kollamparambil
authors.forename: Pammi Venkatesh
authors.initials: PV
authors.lastname: Mohan
authors.forename: Kavitha
authors.initials: K
authors.lastname: Gunasuntharam
authors.forename: Bhavdeep Rameshchandra
authors.initials: BR
authors.lastname: Jani
authors.forename: David Gerard
authors.initials: DG
authors.lastname: Penman
mesh_terms: D020790:Diabetes Insipidus, Neurogenic / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000652:urine; D004573:Electrolytes / Q000097:blood / Q000652:urine; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis*; D006801:Humans; D007231:Infant, Newborn; D009994:Osmolar Concentration; D006831:Polyhydramnios / Q000209:etiology*; D011247:Pregnancy
chemical_list: D004573:Electrolytes