X-Linked Recessive form of Nephrogenic Diabetes Insipidus in a 7-Year-Old Boy.
Nephrogenic diabetes insipidus (NDI) is caused by the inability of renal collecting duct cells to respond to arginine vasopressin (AVP)/antidiuretic hormone (ADH). We present the case of a 7-year-old boy with a history of excretion of large amounts of dilute urine and polydipsia since infancy. The boy had several vomiting episodes with mild dehydration during the first 3 years of life. There was no evidence of headaches, dizziness or visual problems. He drinks between 2 and 3 L/day and has 24-hour diuresis of 2 liters, now. He has prepubertal appearance with appropriate weight [+0.85 standard deviation score (SDS)] and height (+0.15 SDS) for his age. His intelligence was also normal. The water deprivation test showed low urine osmolality after 8 hours of dehydration. After desmopressin administration, urine osmolality remained low. Serum osmolality was in the normal range for sex and age before and after desmopressin administration. This indicated a nephrogenic form of diabetes insipidus. Molecular analyses revealed a P286L [p.Pro(CCC)286Leu(CTC)] mutation in the AVPR2 gene, that was inherited from his mother. This patient is the first case with genetically confirmed X-linked inherited form of NDI in the Republic of Macedonia. Molecular analysis confirmed the clinical diagnosis and enabled genetic advice for this family.
University Children's Hospital Skopje, Medical Faculty, Skopje, Macedonia.
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Janchevska
University Children's Hospital Skopje, Medical Faculty, Skopje, Macedonia.
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Tasic
University Children's Hospital Skopje, Medical Faculty, Skopje, Macedonia.
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Gucev
University Children's Hospital Skopje, Medical Faculty, Skopje, Macedonia.
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Krstevska-Konstantinova
Seoul National University Children's Hospital, Seoul, Korea ; Research Coordination Center for Rare Diseases, Seoul National University Hospital, Seoul, Korea ; Kidney Research Institute, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea.
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Cheong
Antidiuretic hormone (ADH); Arginine vasopressin (AVP); Nephrogenic diabetes insipidus (NDI); Urine osmolality