Background: Central diabetes insipidus (CDI) is caused by deficiency of antidiuretic hormone (ADH). Patients with CDI are at risk for fluid balance disturbances, especially when there is impaired thirst perception or inability to access water freely. Serum sodium measurement gives a good reflection of the actual fluid balance but is generally not available in the home situation. For patients in which CDI is difficult to manage sodium measurement at home may be a good instrument for more self-reliance and possibly less emergency room visits and/ or hospital admissions due to dysregulation of fluid balance.
Aim: We describe a case of a boy with CDI and impaired thirst perception in whom the use of serum sodium, measured by the use of an i-STAT analyzer, has successfully led to more self-reliance and quality of life for him and his family.
Case description: We describe a 5-year old boy with an optical pathway glioma with a complicated course of disease. As a consequence of his treatment he has psychomotor retardation, is blind and developed anterior hypopituitarism and CDI. He has an impaired thirst perception and is behaviorally focused on drinking. He was frequently admitted to the hospital because of dysregulation of his CDI as it was not possible to adequately adapt DDAVP dosage to his drinking behavior in the home situation. We found thei-STAT POCT analyzer (Abbott) to be a reliable system for sodium measurement at home. Expenses were covered by the health insurance company for a trial period (respectively 2 and 3 months). During the trial period there was no need for ER visits or clinical admission due to dysregulation of fluid balance. His parents are more in control, it saves them time and stress due to ER visits/ hospital admissions. It leads to less disturbances in every day family live.
Conclusion: i-STAT sodium home measurement is an excellent example of personalized health care leading to more self-reliance and improvement of quality of life.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology