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Central Diabetes Insipidus (CDI) in Very Low Birth Weight Neonate: Case Report

Received: 2 June 2023     Accepted: 19 June 2023     Published: 11 July 2023
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Abstract

Diabetes Insipidus (DI) is rare, with an estimated incidence of 1 in 25,000 cases; less than 10% of cases are hereditary. CDI accounts for over 90% of DI cases and can appear at any age, depending on the cause. There is no indication that hereditary CDI causes are frequent. Central diabetes insipidus (CDI) is uncommon in neonates, particularly in very low-birth-weight newborns, and the great majority of cases are caused by disorders such as ischemia damage or bleeding brain injury. CDI is caused by a deficiency of antidiuretic hormone (ADH) as a result of posterior pituitary and/or hypothalamus dysfunction. We report a case of female, premature newborn, delivered in Sultan Qaboos Hospital in Salalah at 28 weeks gestational age, with a very low birth weight of 1001 grams. She also suffered polyuria and hypernatremia. The baby had hypernatremia and polyuria and low urine specific gravidity at the same time. Baby was early identified with central diabetes insipidus, we failed to control hypernatremia by fluid compensation but the case was effectively treated and controlled with oral desmopressin. Conclusion: Oral Desmopressin is effective and safe in the treatment of CDI but therapy necessitates frequent monitoring of hydration status, polyuria, serum sodium, and dosage calibration as needed.

Published in American Journal of Pediatrics (Volume 9, Issue 3)
DOI 10.11648/j.ajp.20230903.13
Page(s) 118-121
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2023. Published by Science Publishing Group

Keywords

Central Diabetes Insipidus, Desmopressin, Sultan Qaboos Hospital, Salalah

References
[1] Abuhamda, A. F. "Neonatal Diabetes Insipidus in a Palestinian Newborn." Rossiyskiy Vestnik Perinatologii i Pediatric (Russian Bulletin of Perinatology and Pediatrics) 64.5 (2019): 101-103.
[2] Dabrowski, Elizabeth, Rachel Kadakia, and Donald Zimmerman. "Diabetes insipidus in infants and children." Best practice & research Clinical endocrinology & metabolism 30.2 (2016): 317-328.
[3] Hussain A, Baier RJ, Mehrem AA, Soylu H, Fraser D, Elsayed Y. Central Diabetes Insipidus in a Preterm Neonate Unresponsive to Intranasal Desmopressin. Neonatal Netw. 2020 Nov 1; 39 (6): 339-346. doi: 10.1891/0730-0832/11-T-679. PMID: 33318230.
[4] Zu Park, Yung, et al. "Central diabetes insipidus in an extremely low-birth-weight preterm infant with suspected ectopic posterior lobe of the pituitary gland." Neonatal Medicine 27.1 (2020): 31-36.
[5] Ferlin, Maria Lúcia Silveira, et al. "Central diabetes insipidus: alert for dehydration in very low birth weight infants during the neonatal period. A case report." Sao Paulo Medical Journal 133 (2014): 60-63.
[6] Biset, A., and O. Claris. "Idiopathic central diabetes insipidus in an extreme premature infant: a case report." Archives de Pédiatrie 25.8 (2018): 480-484.
[7] Hanta, Deniz, et al. "Idiopathic central diabetes insipidus presenting in a very low birth weight infant successfully managed with lyophilized sublingual desmopressin." The Turkish Journal of Pediatrics 57.1 (2015): 90.
[8] Ueda, H. et al. "Neonatal central diabetes insipidus caused by severe perinatal asphyxia." Pediatr Ther 6.1 (2016): 278.
[9] Saborio, Pablo, Gary A. Tipton, and James CM Chan. "Diabetes insipidus." Pediatrics in Review 21.4 (2000): 122-129.
[10] Korkmaz, Hüseyin Anıl, et al. "Management of central diabetes insipidus with oral desmopressin lyophilisate in infants." Journal of Pediatric Endocrinology and Metabolism 27.9-10 (2014): 923-927.
[11] Atasay, B., et al. "Management of central diabetes insipidus with oral desmopressin in a premature neonate." Journal of Pediatric Endocrinology and Metabolism 17.2 (2004): 227-230.
[12] Stick, S. M., and P. R. Betts. "Oral desmopressin in neonatal diabetes insipidus." Archives of disease in childhood 62.11 (1987): 1177-1178.
[13] Quetin F. et al. "Persistent central diabetes insipidus in a very low birth weight infant." Archives de Pediatrie: Organe Officiel de la Societe Francaise de Pediatrie 14.11 (2007): 1321-1323.
[14] Sng, A., K. Y. Loke, and Y. Lim. "A case of neonatal central diabetes insipidus in a premature infant: challenges in diagnosis and management." Case Rep J 2.2 (2018): 010.
[15] De Waele, Kathleen, et al. "Desmopressin lyophilisate for the treatment of central diabetes insipidus: first experience in very young infants." International Journal of Endocrinology and Metabolism 12.4 (2014).
[16] Alan, S., et al. "1321 The management of central diabetes insipidus in neonatal intensive care unit: experience of eight cases." Archives of Disease in Childhood 97. Suppl 2 (2012): A376-A377.
[17] Larijani, Bagher, et al. "Comparison of desmopressin (ddavp) tablet and intranasal spray in the treatment of central diabetes insipidus." DARU Journal of Pharmaceutical Sciences 13.4 (2005): 155-159.
Cite This Article
  • APA Style

    Allam Fayez Mahmoud Abuhamda. (2023). Central Diabetes Insipidus (CDI) in Very Low Birth Weight Neonate: Case Report. American Journal of Pediatrics, 9(3), 118-121. https://doi.org/10.11648/j.ajp.20230903.13

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    ACS Style

    Allam Fayez Mahmoud Abuhamda. Central Diabetes Insipidus (CDI) in Very Low Birth Weight Neonate: Case Report. Am. J. Pediatr. 2023, 9(3), 118-121. doi: 10.11648/j.ajp.20230903.13

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    AMA Style

    Allam Fayez Mahmoud Abuhamda. Central Diabetes Insipidus (CDI) in Very Low Birth Weight Neonate: Case Report. Am J Pediatr. 2023;9(3):118-121. doi: 10.11648/j.ajp.20230903.13

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  • @article{10.11648/j.ajp.20230903.13,
      author = {Allam Fayez Mahmoud Abuhamda},
      title = {Central Diabetes Insipidus (CDI) in Very Low Birth Weight Neonate: Case Report},
      journal = {American Journal of Pediatrics},
      volume = {9},
      number = {3},
      pages = {118-121},
      doi = {10.11648/j.ajp.20230903.13},
      url = {https://doi.org/10.11648/j.ajp.20230903.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20230903.13},
      abstract = {Diabetes Insipidus (DI) is rare, with an estimated incidence of 1 in 25,000 cases; less than 10% of cases are hereditary. CDI accounts for over 90% of DI cases and can appear at any age, depending on the cause. There is no indication that hereditary CDI causes are frequent. Central diabetes insipidus (CDI) is uncommon in neonates, particularly in very low-birth-weight newborns, and the great majority of cases are caused by disorders such as ischemia damage or bleeding brain injury. CDI is caused by a deficiency of antidiuretic hormone (ADH) as a result of posterior pituitary and/or hypothalamus dysfunction. We report a case of female, premature newborn, delivered in Sultan Qaboos Hospital in Salalah at 28 weeks gestational age, with a very low birth weight of 1001 grams. She also suffered polyuria and hypernatremia. The baby had hypernatremia and polyuria and low urine specific gravidity at the same time. Baby was early identified with central diabetes insipidus, we failed to control hypernatremia by fluid compensation but the case was effectively treated and controlled with oral desmopressin. Conclusion: Oral Desmopressin is effective and safe in the treatment of CDI but therapy necessitates frequent monitoring of hydration status, polyuria, serum sodium, and dosage calibration as needed.},
     year = {2023}
    }
    

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    T1  - Central Diabetes Insipidus (CDI) in Very Low Birth Weight Neonate: Case Report
    AU  - Allam Fayez Mahmoud Abuhamda
    Y1  - 2023/07/11
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    N1  - https://doi.org/10.11648/j.ajp.20230903.13
    DO  - 10.11648/j.ajp.20230903.13
    T2  - American Journal of Pediatrics
    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
    SP  - 118
    EP  - 121
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    UR  - https://doi.org/10.11648/j.ajp.20230903.13
    AB  - Diabetes Insipidus (DI) is rare, with an estimated incidence of 1 in 25,000 cases; less than 10% of cases are hereditary. CDI accounts for over 90% of DI cases and can appear at any age, depending on the cause. There is no indication that hereditary CDI causes are frequent. Central diabetes insipidus (CDI) is uncommon in neonates, particularly in very low-birth-weight newborns, and the great majority of cases are caused by disorders such as ischemia damage or bleeding brain injury. CDI is caused by a deficiency of antidiuretic hormone (ADH) as a result of posterior pituitary and/or hypothalamus dysfunction. We report a case of female, premature newborn, delivered in Sultan Qaboos Hospital in Salalah at 28 weeks gestational age, with a very low birth weight of 1001 grams. She also suffered polyuria and hypernatremia. The baby had hypernatremia and polyuria and low urine specific gravidity at the same time. Baby was early identified with central diabetes insipidus, we failed to control hypernatremia by fluid compensation but the case was effectively treated and controlled with oral desmopressin. Conclusion: Oral Desmopressin is effective and safe in the treatment of CDI but therapy necessitates frequent monitoring of hydration status, polyuria, serum sodium, and dosage calibration as needed.
    VL  - 9
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    ER  - 

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Author Information
  • Neonatal ICU, Sultan Qaboos Hospital, Salalah, Dhofar, Sultanate of Oman

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