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Eur J Pediatr. 2011 May;170(5):653-6. doi: 10.1007/s00431-010-1340-2. Epub 2010 Nov 12.

Prenatal presentation of transient central diabetes insipidus.

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  • 1Royal Gwent Hospital, Newport, Gwent NB20 2UB, UK.

Abstract

INTRODUCTION:

Nephrogenic diabetes insipidus (DI) in the foetus has been described as a rare presentation of severe polyhydramnios.

DISCUSSION:

We report a case of foetal central DI, characterised by severe polyhydramnios. Significant polyuria was noted at birth. Serum AVP level was un-measurable (<0.5 pg/ml). A dramatic response to intravenous dDAVP (desmopressin) was noted confirming central DI. Further investigations did not reveal a recognised cause for central or nephrogenic DI. The infant thrived well on a small dose of oral desmopressin until the age of 12 months. At 13 months, a water deprivation test revealed a normal ability to concentrate urine without desmopressin, and subsequently, the infant has thrived without further treatment. The transient nature of the central DI remains obscure but could be explained by a maturational delay in the tissues involved in AVP synthesis or release, during intrauterine life and infancy.

CONCLUSION:

Both nephrogenic and central DI should be considered as a cause of severe polyhydramnios. This may help to guide prompt intensive management and investigation, with attention to vascular access, central venous pressure, urine output monitoring and replacement.

PMID:
21072537
[PubMed - indexed for MEDLINE]
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