Lee Yvonne, Winnicki Erica, Butani Lavjay, Nguyen Stephanie
Department of Pediatrics, Section of Endocrinology, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA.
Department of Pediatrics, Section of Nephrology, University of California, San Francisco, San Francisco, CA, USA.
Case Rep Pediatr. 2018 Aug 23;2018:4281217. doi: 10.1155/2018/4281217. eCollection 2018.
Psychogenic polydipsia is a well-described phenomenon in those with a diagnosed psychiatric disorder such as schizophrenia and anxiety disorders. Primary polydipsia is differentiated from psychogenic polydipsia by the lack of a clear psychotic disturbance. We present a case of a 27-month-old boy who presented with polyuria and polydipsia. Laboratory studies, imaging, and an observed water deprivation test were consistent with primary polydipsia. Polydipsia resolved after family limited his fluid intake and began replacing water drinking with other transition objects and behaviors for self-soothing. This case highlights the importance of water deprivation testing to differentiate between causes of polyuria, thereby avoiding misdiagnosis and iatrogenic hyponatremia. Secondly, primary polydipsia can result during the normal stages of child development without overt psychiatric disturbances.
精神性烦渴是一种在患有精神疾病(如精神分裂症和焦虑症)的患者中被充分描述的现象。原发性烦渴与精神性烦渴的区别在于不存在明显的精神障碍。我们报告一例27个月大的男孩,他出现了多尿和烦渴症状。实验室检查、影像学检查以及观察到的禁水试验结果均符合原发性烦渴。在家人限制其液体摄入量,并开始用其他过渡物品和自我安抚行为替代饮水后,烦渴症状得到缓解。该病例强调了禁水试验对于区分多尿原因的重要性,从而避免误诊和医源性低钠血症。其次,原发性烦渴可在儿童发育的正常阶段出现,而无明显的精神障碍。