Krebs V L, Damiani D, Diniz M de A, Ceccon M E, Yoshimoto C, Aguiar I F, Setian N, Ramos J L, Vaz F A
Neonatal Intensive Care Unit, Instituto da Criança, São Paulo University School of Medicine, Brasil.
Acta Paediatr Jpn. 1998 Apr;40(2):146-9. doi: 10.1111/j.1442-200x.1998.tb01900.x.
Three patients, 11, 17 and 41 days old with various degrees of central nervous system (CNS) lesions developed central diabetes insipidus as a complication of hypothalamic damage. Two of the children had congenital CNS malformations including meningomyelocele, hydrocephalus, and prosencephaly, while the third child presented Streptococcus agalactiae meningitis, complicated with CNS hemorrhage and hypertensive dilatation of the lateral ventricles. All of them fulfilled the criteria for central diabetes insipidus, reaching high levels of serum sodium and osmolality, along with hypotonic urine. The responses to intranasal arginine-vasopressin were prompt, normalizing the serum levels of sodium and increasing urinary osmolality, allowing a better metabolic balance, avoiding continuing damage to the already compromised CNS. The neonatologist must be aware of the possibility of this kind of complication even in a normal child with CNS infection. Imaging studies showing hemorrhage in the region of the posterior hypothalamus must be a sign that this type of complication is able to occur.
三名年龄分别为11天、17天和41天的患有不同程度中枢神经系统（CNS）损伤的患儿，出现了中枢性尿崩症，这是下丘脑损伤的一种并发症。其中两名儿童患有先天性CNS畸形，包括脊髓脊膜膨出、脑积水和前脑无裂畸形，而第三名儿童患有无乳链球菌脑膜炎，并伴有CNS出血和侧脑室高血压性扩张。他们均符合中枢性尿崩症的标准，血清钠和渗透压水平升高，同时伴有低渗尿。对鼻内注射精氨酸加压素的反应迅速，使血清钠水平恢复正常，并增加尿渗透压，从而实现更好的代谢平衡，避免对本已受损的CNS造成持续损害。新生儿科医生必须意识到，即使是患有CNS感染的正常儿童也有可能出现这种并发症。显示下丘脑后部区域出血的影像学研究必须被视为这种类型并发症可能发生的迹象。
