ESPE Abstracts

Background: Congenital adiptical diabetes insipidus is rare condition in infancy. Immediate diagnosis and treatment is required to ensure normal development.

Case report: A boy, from the 2nd pregnancy, 1st term delivery was born with weight 4480 g. Bottle feeding from the 1st months. Weight at 1st months – 4500 g, at 2nd – 5000 g. Until the first 2 months mother complained on child’s apathia, feeding problems, vomiting, weight stagnation. At 2 months of age all these symptoms increased. A child was consulted by surgeon and neurologist no problems were found. A boy was dehydrated, and sent to the intensive care department of University hospital (Minsk), than to the endocrinological department. Pathological laboratory findings: Na 151–170 (norm 132–145 mmol/l), K – 3.4–5.1 (3.1–5.1 mmol/l), heamoglobin – 87–119, ph 7.34–7.44 (7.35–7.45), ABE (−3.5)−3.8 ((−2)−3) mmol/l), SBE (−1.9)−3.9 ((−1.5)−3 mmol/l), pO2 58.1–80.7 (65–95 mmHg), pCO2 – 34–44.2 (35–45 mmHg) urine density 1001–1003. Hormonal assay: TSH 1.9 (norm: 0.3–4 IU/ml), free T₄ – 17 (11–23 nmol/ml), cortisole 486–1367 (170–720 nmol/ml), aldosterone 1344 (<1900 ng/ml). On the neurosonography little brain vessel cyst was found without any hemodynamic changes. The urine volume was increased (4 ml/kg per h). Congenital diabetes insipidus adiptical variant was diagnosed. The boy was giving desmopressine 0.3 mg/daily, feeding with low levels of Na, but his condition was not still stable, so, hypothyazide 25 mg/daily was added. At the age of 4 months mother came to the endocrinologist and complained on apathia, vomiting. Height 63 cm, weight 6630 g., blood pressure 120/60, urine density 1006–1007, Na 142 mmol/l, K 4.6 mmol/l. Brain MRI with contrast showed middle periventricular oedema. Enalapril 5 mg/daily and metoclopramide 10 mg/daily (continuing vomiting) were added to the treatment. Symptomatic arterial hypertension was added to the diagnosis.

Conclusion: Reported case of congenital adiptical diabetes insipidus in infancy is rare and such cases in Belarus are limited.