Differential diagnosis of diabetes insipidus syndrome on the example of clinical cases
Background. DDiagnosis of various forms of diabetes insipidus in childhood causes significant difficulties, as it is a complex multi-part process. The young age of patients often does not allow for a number of diagnostic tests, which makes it difficult to make a diagnosis.Objective. To carry out a c...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | Russian |
| Published: |
Open Systems Publication
2025-06-01
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| Series: | Лечащий Врач |
| Subjects: | |
| Online Access: | https://journal.lvrach.ru/jour/article/view/1431 |
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| Summary: | Background. DDiagnosis of various forms of diabetes insipidus in childhood causes significant difficulties, as it is a complex multi-part process. The young age of patients often does not allow for a number of diagnostic tests, which makes it difficult to make a diagnosis.Objective. To carry out a comparative characterization of different forms of non-sugar diabetes in children on the example of three patients.Materials and methods. The results of observation of three patients hospitalized with complaints of polyuria and polydipsia are presented. The anamnesis and clinical manifestations of the disease were studied. The examination included a general blood and urine analysis, Zimnitsky's test, biochemical blood analysis, ABB, ultrasound of the urinary system, MRI of the pituitary gland, tests with fluid deprivation and desmopressin, molecular genetic study.Results. In a child aged 1.7 years, after elimination of the habit of almost constant liquid consumption through a pacifier, normalization of daily diuresis and increase in relative urine density up to 1015 were obtained. This made it possible to diagnose psychogenic polydipsia. In a 7.4-year-old patient with a family history of nonsugar diabetes, polyuria and low relative urine density persisted on the background of fluid deprivation, desmopressin prescription did not lead to a positive result. Nephrogenic non-sugar diabetes was diagnosed, which was subsequently confirmed by molecular genetic examination, and the child was placed under the supervision of a nephrologist. Early onset of the disease, increasing thirst and polyuria with age, impaired well-being, persistence of polyuria and low relative urine density, as well as a tendency to improvement of the indicators against the background of desmopressin use, made it possible to establish the diagnosis of central non-sugar diabetes. The patient was recommended free access to fluids, treatment with desmopressin was prescribed, under control of the child's well-being, thirst, daily diuresis volume, electrolyte composition of blood serum, blood pressure, body weight dynamics. |
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| ISSN: | 1560-5175 2687-1181 |