Papaefthimiou Apostolos, Kyrgios Ioannis, Kotanidou Eleni P, Maggana Ioanna, Mouzaki Konstantina, Galli-Tsinopoulou Assimina
4th Department of Pediatrics, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Ring Road Nea Efkarpia, 564 03 Thessaloniki, Greece.
4th Department of Pediatrics, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Ring Road Nea Efkarpia, 564 03 Thessaloniki, Greece.
Ann Endocrinol (Paris). 2015 Feb;76(1):67-70. doi: 10.1016/j.ando.2014.11.001. Epub 2014 Nov 11.
Nocturnal enuresis is a common symptom in children. It is usually attributed to benign causes and diagnostic evaluation is not carried out. We report three male young patients initially presenting with short stature and nocturnal enuresis, related to diabetes insipidus, caused by intracranial germinomatous germ cell tumors. In all three cases, water deprivation tests confirmed diabetes insipidus. Extensive endocrinological investigation also showed further hormone deficiencies. Magnetic resonance imaging of the brain revealed the presence of a central nervous system lesion and histology confirmed the final diagnosis. Surgery, radiation with or without chemotherapy was conducted and the patients were treated with hormone replacement therapies. The patients after a long follow-up were free of disease. We present these cases to alert clinicians to bear in mind that the presence of an intracranial germinomatous germ cell tumor should at least be considered in a child presenting with bed wetting, especially if additional symptoms and signs, including late onset puberty and growth delay or morning hypernatremia, may coexist.
夜间遗尿是儿童常见症状。通常归因于良性原因，未进行诊断评估。我们报告了三名男性年轻患者，最初表现为身材矮小和夜间遗尿，与颅咽管瘤导致的尿崩症有关。在所有三例中，禁水试验证实为尿崩症。广泛的内分泌检查还显示存在其他激素缺乏。脑部磁共振成像显示存在中枢神经系统病变，组织学检查确诊了最终诊断。进行了手术、放疗（有或无化疗），并对患者进行了激素替代治疗。经过长期随访，患者无疾病复发。我们展示这些病例是为了提醒临床医生，对于出现尿床的儿童，尤其是如果同时存在包括青春期发育延迟、生长迟缓或晨起高钠血症等其他症状和体征时，应至少考虑颅内颅咽管瘤的存在。
