Kim Faith, Towers Helen M
Department of Pediatrics, Division of Neonatology, Columbia University Medical Center/NewYork-Presbyterian Morgan Stanley Children's Hospital of New York, New York City, NY, USA.
J Neonatal Perinatal Med. 2021;14(2):293-297. doi: 10.3233/NPM-200465.
Central diabetes insipidus (CDI) may occur in the setting of intracranial abnormalities that affect the hypothalamus-pituitary system. It occurs rarely in neonates, especially in the premature population, and represents a challenging disease process to treat pharmacologically. Little is known regarding the treatment options in premature infants, including dose and route of administration of intravenous desmopressin (DDAVP). We present a case of a late premature male infant with gastroschisis and septo-optic dysplasia who developed transient CDI. He was treated with intravenous DDAVP but required frequent laboratory monitoring and a multidisciplinary approach, and ultimately his CDI resolved. Although there are minimal guidelines regarding the appropriate formulation and dosage of DDAVP for management of CDI in infants, we initiated the lowest dose available and titrated the medication based on close monitoring of urine output and serum sodium levels in order to successfully treat his transient CDI.
中枢性尿崩症（CDI）可能发生在影响下丘脑 - 垂体系统的颅内异常情况下。它在新生儿中很少见，尤其是早产儿，并且是一种在药理学治疗上具有挑战性的疾病过程。关于早产儿的治疗选择，包括静脉注射去氨加压素（DDAVP）的剂量和给药途径，人们知之甚少。我们报告一例患有腹裂和视隔发育不良的晚期早产儿发生短暂性CDI的病例。他接受了静脉注射DDAVP治疗，但需要频繁的实验室监测和多学科方法，最终他的CDI得到缓解。尽管关于用于婴儿CDI管理的DDAVP的合适剂型和剂量的指南很少，但我们开始使用可用的最低剂量，并根据对尿量和血清钠水平的密切监测来调整药物剂量，以便成功治疗他的短暂性CDI。
