Department of Pediatrics, Hospital Universitario Central de Asturias, Oviedo, Spain.
BMC Pediatr. 2012 May 28;12:56. doi: 10.1186/1471-2431-12-56.
Most cases of neonatal central diabetes insipidus are caused by an injury, which often results in other handicaps in the patient. The infant's prognosis will be determined by his or her own early age and disability as well as by the physician's skill. However, the rarity of this condition prevents the acquisition of personal experience dealing with it.
A neonatal hemorrhagic stroke, caused by an aortic coarctation, caused right lower limb paresis, swallowing disability, and central diabetes insipidus in a term infant. The scant oral intake, as a consequence of his disability, caused progressive undernutrition which closed a vicious circle, delaying his development and his ability to overcome the swallowing handicap. On the other hand, nasal desmopressin absorption was blocked by several common colds, resulting in brain bleeding because of severe dehydration. This even greater brain damage hampered the improvement of swallowing, closing a second harmful circle. Moreover, a devastating central myelinolysis with quadriplegia, caused by an uncontrolled intravenous infusion, consummated a pernicious sequence, possibly unreported.
The child's overall development advanced rapidly when his nutrition was improved by gastrostomy: This was a key effect of nutrition on his highly sensitive neurodevelopment. Besides, this case shows potential risks related to intranasal desmopressin treatment in young children.
大多数新生儿中枢性尿崩症是由损伤引起的，这往往会导致患者出现其他残疾。婴儿的预后将取决于他或她的早期年龄和残疾以及医生的技能。然而，这种情况的罕见性阻止了个人经验的获取。
一名足月婴儿因主动脉缩窄引起的新生儿脑出血导致右下肢瘫痪、吞咽障碍和中枢性尿崩症。由于残疾，他的口腔摄入量很少，导致进行性营养不良，从而形成恶性循环，阻碍了他的发育和克服吞咽障碍的能力。另一方面，由于多次普通感冒，鼻内去氨加压素吸收受阻，导致严重脱水引起的脑出血。这对吞咽功能的改善造成了更大的损害，形成了第二个恶性循环。此外，由于不受控制的静脉输液，导致四肢瘫痪的破坏性中央脑桥髓鞘溶解症，完成了一个可能未报道的有害序列。
当通过胃造口术改善患儿的营养状况时，其整体发育迅速进步：这是营养对其高度敏感神经发育的关键影响。此外，该病例显示了与年幼儿童经鼻内给予去氨加压素治疗相关的潜在风险。
