Madalena C, Sameiro-Faria M, Coelho B, Martins E, Mota C, Pereira E
Hospital Geral de Santo Antonio, Porto, Portugal.
Rev Neurol. 2002;35(5):433-5.
Diabetes insipidus (DI) is a syndrome characterised by polyuria which is almost always associated with polydipsia. The most frequent cause is central DI, which is the result of an inadequate secretion of the diuretic hormone, and diagnosis involves differentiating it from other causes of polyuria and polydipsia.
The authors report the clinical case of a previously healthy 4 year old girl, who, in December 1998, was found to have intense polydipsia accompanied by polyuria. Behavioural treatment was begun as an answer to what was thought to be psychogenic polydipsia, although results were unsatisfactory and the patient was brought to the Paediatric Nephrology Service at Hospital Maria Pia in June 1999.
A clinical study, which included the water restriction test and concentration tests with desmopressin, enabled us to diagnose central DI. In spite of the results from a cranial NMR scan being normal, follow up time is still too short to classify the aetiology as idiopathic. The girl is asymptomatic under treatment with intranasal desmopressin. The favourable evolution in this case highlights the need to act in a thorough manner in the study of situations involving polyuria/polydipsia.
尿崩症(DI)是一种以多尿为特征的综合征,几乎总是伴有烦渴。最常见的病因是中枢性尿崩症,这是抗利尿激素分泌不足的结果,诊断需要将其与其他导致多尿和烦渴的病因区分开来。
作者报告了一名4岁健康女童的临床病例,该女童于1998年12月被发现有强烈的烦渴并伴有多尿。开始进行行为治疗,认为这是精神性烦渴的表现,尽管结果并不理想,该患者于1999年6月被送往玛丽亚·皮娅医院的儿科肾脏病科。
一项包括禁水试验和去氨加压素浓缩试验的临床研究使我们能够诊断出中枢性尿崩症。尽管头颅核磁共振扫描结果正常,但随访时间仍然太短,无法将病因归类为特发性。该女童在接受鼻内去氨加压素治疗时无症状。该病例的良好进展突出了在研究多尿/烦渴情况时需要采取全面行动的必要性。