title: Congenital toxoplasmosis presenting as central diabetes insipidus in an infant: a case report.
abstract: BACKGROUND
  Congenital toxoplasmosis has a wide range of presentation at birth varying from severe neurological features such as hydrocephalus and chorioretinitis to a well appearing baby, who may develop complications late in infancy. While neuroendocrine abnormalities associated with congenital toxoplasmosis are uncommon, isolated central diabetes insipidus is extremely rare.
  
  
  METHODS
  Here, we report on a female infant who presented with fever, convulsions, and polyuria. Examination revealed weight and length below the 3rd centile along with signs of severe dehydration. Fundal examination showed bilateral chorioretinitis. This infant developed hypernatremia together with increased serum osmolality and decreased both urine osmolality and specific gravity consistent with central diabetes insipidus. Serology for toxoplasma specific immunoglobulin M was high for both the mother and the baby and polymerase chain reaction for toxoplasma deoxyribonucleic acid was positive in the infant confirming congenital toxoplasmosis. Brain computerized tomography scans demonstrated ventriculomegaly associated with cerebral and cortical calcifications. Fluid and electrolyte abnormalities responded to nasal vasopressin therapy.
  
  
  CONCLUSIONS
  This report highlights central diabetes inspidus as a rare presentation of congenital toxoplasmosis.
authors.affiliation: Department of Pediatrics (39), College of Medicine, King Saud University, P,O, Box 2925, 11461 Riyadh, Saudi Arabia. sararmohamed@hotmail.com.
authors.forename: Sarar
authors.initials: S
authors.lastname: Mohamed
authors.forename: Abdaldafae
authors.initials: A
authors.lastname: Osman
authors.forename: Nasir A
authors.initials: NA
authors.lastname: Al Jurayyan
authors.forename: Abdulrahman
authors.initials: A
authors.lastname: Al Nemri
authors.forename: Mustafa A M
authors.initials: MA
authors.lastname: Salih
mesh_terms: D000328:Adult; D000913:Antibodies, Protozoan / Q000097:blood*; D001921:Brain / Q000000981:diagnostic imaging / Q000469:parasitology / Q000473:pathology*; D020790:Diabetes Insipidus, Neurogenic / Q000150:complications / Q000151:congenital* / Q000000981:diagnostic imaging / Q000469:parasitology; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D007223:Infant; D011859:Radiography; D014122:Toxoplasma / Q000472:pathogenicity / Q000502:physiology; D014125:Toxoplasmosis, Congenital / Q000150:complications / Q000000981:diagnostic imaging / Q000469:parasitology / Q000473:pathology*
chemical_list: D000913:Antibodies, Protozoan; D007075:Immunoglobulin M