title: Central diabetes insipidus in children with acute brain insult.
abstract: Central diabetes insipidus occurs in patients with overwhelming central nervous system injuries, and may be associated with brain death. The clinical picture of children with acquired central diabetes insipidus after acute brain insult is seldom reported. We retrospectively reviewed cases dating from January 2000-February 2008 at a tertiary pediatric intensive care unit. Fifty-four patients (28 girls, 26 boys), aged 3 months to 18 years, were enrolled. Etiologies included severe central nervous system infection (35.2%), hypoxic-ischemic events (31.5%), head injury (18.5%), and vascular lesions (14.8%). In 39 (72.2%) patients, diabetes insipidus was diagnosed during the first 2 days after acute central nervous system injury, and 40 (74.0%) developed maximum serum sodium concentrations of >160 mEq/L. In 16, sequential cerebral salt wasting syndrome developed after their initial diabetes insipidus presentation. Overall mortality at 2 months after admission was 77.8%. Our results demonstrate that patients who develop central diabetes insipidus after acute central nervous system injury manifest high mortality. Development of central diabetes insipidus within the first 2 days and a maximum plasma sodium >160 mEq/L were significant predictors of outcomes.
authors: Division of Pediatric Neurology, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors: Yun-Hsuan
authors: YH
authors: Yang
authors: Jainn-Jim
authors: JJ
authors: Lin
authors: Shao-Hsuan
authors: SH
authors: Hsia
authors: Chang-Teng
authors: CT
authors: Wu
authors: Huei-Shyong
authors: HS
authors: Wang
authors: Po-Cheng
authors: PC
authors: Hung
authors: Min-Liang
authors: ML
authors: Chou
authors: Meng-Ying
authors: MY
authors: Hsieh
authors: Kuang-Lin
authors: KL
authors: Lin
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001930:Brain Injuries / Q000150:complications* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D020790:Diabetes Insipidus, Neurogenic / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012964:Sodium / Q000097:blood; D013223:Statistics as Topic
chemical_list: D012964:Sodium