Rare neonatal diabetes insipidus and associated late risks: case report.
BACKGROUND
Most cases of neonatal central diabetes insipidus are caused by an injury, which often results in other handicaps in the patient. The infant's prognosis will be determined by his or her own early age and disability as well as by the physician's skill. However, the rarity of this condition prevents the acquisition of personal experience dealing with it.


METHODS
A neonatal hemorrhagic stroke, caused by an aortic coarctation, caused right lower limb paresis, swallowing disability, and central diabetes insipidus in a term infant. The scant oral intake, as a consequence of his disability, caused progressive undernutrition which closed a vicious circle, delaying his development and his ability to overcome the swallowing handicap. On the other hand, nasal desmopressin absorption was blocked by several common colds, resulting in brain bleeding because of severe dehydration. This even greater brain damage hampered the improvement of swallowing, closing a second harmful circle. Moreover, a devastating central myelinolysis with quadriplegia, caused by an uncontrolled intravenous infusion, consummated a pernicious sequence, possibly unreported.


CONCLUSIONS
The child's overall development advanced rapidly when his nutrition was improved by gastrostomy: This was a key effect of nutrition on his highly sensitive neurodevelopment. Besides, this case shows potential risks related to intranasal desmopressin treatment in young children.
Department of Pediatrics, Hospital Universitario Central de Asturias, Oviedo, Spain. rivascrespo@gmail.com
Maximiliano Francisco
MF
Rivas-Crespo
Lorena
L
Miñones-Suárez
Susana Serrano
SS
G-Gallarza
D050034:Antidiuretic Agents / Q000627:therapeutic use; D001017:Aortic Coarctation / Q000150:complications* / Q000175:diagnosis; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use; D003680:Deglutition Disorders / Q000209:etiology; D020790:Diabetes Insipidus, Neurogenic / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011782:Quadriplegia / Q000209:etiology; D020521:Stroke / Q000150:complications* / Q000175:diagnosis
D050034:Antidiuretic Agents; D003894:Deamino Arginine Vasopressin