Clinical profile of patients with Central Diabetes Insipidus at the Endocrinology Unit of Instituto Nacional de Salud del Niño (INSN) during 2001 -2010. Lima – Peru

Abstract

Objective: The aim of the study was to describe the clinical characteristics of the patients with central insipidus diabetes evaluated at the endocrinology unit of the INSN during a period of ten years (January 2001 to December 2010).

Methods: A retrospective review of all the patients between 1 month and 17 years 11 months of age diagnosed of central diabetes insipidus from January 1st 2001 to December 31th 2010 at the endocrinology unit that met the inclusion criteria. Only complete charts were included. Clinical variables were investigated with descriptive statistical analysis.

Results: From the 149 clinical charts we selected 38 patients (65.8% male). The median age at diagnosis was 7.5± 3.68 years (0.08 – 16). The major percentage of patients was school age children between 6 and 10 years (39.5%). Etiology diagnosis was possible in a significant proportion (84.2%) of children with central diabetes insipidus. The etiology of central DI was acquired in 97.4%, being the intracranial tumors (57.9%) the most frequent and in first place craniopharyngioma (42.1%). For clinical manifestations 100% of patients had polyuria; 78.9%, polydipsia; headache, 23.7%; nicturia, 21.1%; short stature, 10.5%; vomit, 7.9%; fatigue, 5.3%, loss of weight, 2.6%. 39.4% of patients had an anterior pituitary endocrine abnormality being the TSH deficiency (36.8%) and the ACTH deficiency the most frequent (34.2%).

Conclusions: Central diabetes insipidus affected more frequently males and school age children. Etiology diagnosis is possible in a significant proportion of children with central diabetes insipidus. The acquired forms of DI are the most common, being intracranial tumors at the top specially craniopharyngioma. Accompanying abnormal anterior pituitary function is most often encountered with special emphasis in TSH deficiency and ACTH deficiency.