title: Management of diabetes insipidus and adipsia in the child.
abstract: Central diabetes insipidus (CDI) is a complex and heterogeneous clinical syndrome affecting the hypothalamic-neurohypophyseal network and water balance. A recent national surveillance in Denmark showed a prevalence rate of twenty-three CDI patients per 100,000 inhabitants in five years. The differential diagnosis between several presenting conditions with polyuria and polydipsia is puzzling, and the etiological diagnosis of CDI remains a challenge before the identification of an underlying cause. For clinical practice, a timely diagnosis for initiating specific treatment in order to avoid central nervous system damage, additional pituitary defects and the risk of dissemination of germ cell tumor is advisable. Proper etiological diagnosis can be achieved via a series of steps that start with careful clinical observation of several signs and endocrine symptoms and then progress to more sophisticated imaging tools. This review summarizes the best practice and approach for the diagnosis and treatment of patients with CDI.
authors.affiliation: Department of Pediatrics, Istituto Giannina Gaslini, University of Genova, Genova, Italy.
authors.forename: Natascia
authors.initials: N
authors.lastname: Di Iorgi
authors.affiliation: Department of Pediatric Neuroradiology, Istituto Giannina Gaslini, University of Genova, Genova, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Morana
authors.affiliation: Department of Pediatrics, Istituto Giannina Gaslini, University of Genova, Genova, Italy.
authors.forename: Flavia
authors.initials: F
authors.lastname: Napoli
authors.affiliation: Department of Pediatrics, Istituto Giannina Gaslini, University of Genova, Genova, Italy.
authors.forename: Anna Elsa Maria
authors.initials: AE
authors.lastname: Allegri
authors.affiliation: Department of Pediatric Neuroradiology, Istituto Giannina Gaslini, University of Genova, Genova, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Rossi
authors.affiliation: Department of Pediatrics, Istituto Giannina Gaslini, University of Genova, Genova, Italy. Electronic address: mohamadmaghnie@ospedale-gaslini.ge.it.
authors.forename: Mohamad
authors.initials: M
authors.lastname: Maghnie
mesh_terms: D050034:Antidiuretic Agents / Q000627:therapeutic use; D001930:Brain Injuries / Q000150:complications / Q000175:diagnosis*; D001932:Brain Neoplasms / Q000150:complications / Q000175:diagnosis*; D002648:Child; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use; D003919:Diabetes Insipidus / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D020790:Diabetes Insipidus, Neurogenic / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D003937:Diagnosis, Differential; D019468:Disease Management; D006646:Histiocytosis, Langerhans-Cell / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging; D009373:Neoplasms, Germ Cell and Embryonal / Q000150:complications / Q000175:diagnosis*
chemical_list: D050034:Antidiuretic Agents; D003894:Deamino Arginine Vasopressin
keywords: adipsia; anterior pituitary; desmopressin; diabetes insipidus; germ cell tumors; langerhans cell histiocytosis; pituitary stalk; polydipsia; polyuria; posterior pituitary