Central diabetes insipidus: alert for dehydration in very low birth weight infants during the neonatal period. A case report
Autor(a) principal: | |
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Data de Publicação: | 2015 |
Outros Autores: | , , |
Tipo de documento: | Relatório |
Idioma: | eng |
Título da fonte: | São Paulo medical journal (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802015000100060 |
Resumo: | CONTEXT: Central diabetes insipidus (CDI) is a rare cause of hypernatremia during the neonatal period. The diagnosis is particularly difficult in very low birth weight (VLBW) newborns. CASE REPORT: We report on a preterm newborn who presented CDI soon after birth. On the third day of life, signs of dehydration were present despite normal fluid supply. The diuresis rate was 4.4 ml/kg/h. Although the fluid supply was then increased, the dehydration continued, with hypernatremia, normal glycemia, diuresis of 7.4 ml/kg/h and urine density of 1005 mOsmol/l. Thus, a diagnostic hypothesis of diabetes insipidus was raised. A test with a nasal vasopressin analogue (dDAVP) was performed and CDI was confirmed. Reduction of the fluid supply became possible through appropriate treatment. CONCLUSION: The diagnosis of CDI is rarely made during the neonatal period, especially in VLBW newborns, because of the difficulty in detecting elevated diuresis. Persistent hypernatremia, usually accompanied by hyperthermia despite abundant fluid supply, weight loss and low urine osmolality are important signs of alert. |
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Central diabetes insipidus: alert for dehydration in very low birth weight infants during the neonatal period. A case reportDiabetes insipidus, neurogenicInfant, very low birth weightHypernatremiaDehydrationInfant, newborn CONTEXT: Central diabetes insipidus (CDI) is a rare cause of hypernatremia during the neonatal period. The diagnosis is particularly difficult in very low birth weight (VLBW) newborns. CASE REPORT: We report on a preterm newborn who presented CDI soon after birth. On the third day of life, signs of dehydration were present despite normal fluid supply. The diuresis rate was 4.4 ml/kg/h. Although the fluid supply was then increased, the dehydration continued, with hypernatremia, normal glycemia, diuresis of 7.4 ml/kg/h and urine density of 1005 mOsmol/l. Thus, a diagnostic hypothesis of diabetes insipidus was raised. A test with a nasal vasopressin analogue (dDAVP) was performed and CDI was confirmed. Reduction of the fluid supply became possible through appropriate treatment. CONCLUSION: The diagnosis of CDI is rarely made during the neonatal period, especially in VLBW newborns, because of the difficulty in detecting elevated diuresis. Persistent hypernatremia, usually accompanied by hyperthermia despite abundant fluid supply, weight loss and low urine osmolality are important signs of alert. Associação Paulista de Medicina - APM2015-02-01info:eu-repo/semantics/reportinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802015000100060Sao Paulo Medical Journal v.133 n.1 2015reponame:São Paulo medical journal (Online)instname:Associação Paulista de Medicinainstacron:APM10.1590/1516-3180.2012.6450001info:eu-repo/semantics/openAccessFerlin,Maria Lúcia SilveiraSales,Débora SimoneCelini,Fábia Pereira MartinsMartinelli Junior,Carlos Eduardoeng2015-08-04T00:00:00Zoai:scielo:S1516-31802015000100060Revistahttp://www.scielo.br/spmjhttps://old.scielo.br/oai/scielo-oai.phprevistas@apm.org.br1806-94601516-3180opendoar:2015-08-04T00:00São Paulo medical journal (Online) - Associação Paulista de Medicinafalse |
dc.title.none.fl_str_mv |
Central diabetes insipidus: alert for dehydration in very low birth weight infants during the neonatal period. A case report |
title |
Central diabetes insipidus: alert for dehydration in very low birth weight infants during the neonatal period. A case report |
spellingShingle |
Central diabetes insipidus: alert for dehydration in very low birth weight infants during the neonatal period. A case report Ferlin,Maria Lúcia Silveira Diabetes insipidus, neurogenic Infant, very low birth weight Hypernatremia Dehydration Infant, newborn |
title_short |
Central diabetes insipidus: alert for dehydration in very low birth weight infants during the neonatal period. A case report |
title_full |
Central diabetes insipidus: alert for dehydration in very low birth weight infants during the neonatal period. A case report |
title_fullStr |
Central diabetes insipidus: alert for dehydration in very low birth weight infants during the neonatal period. A case report |
title_full_unstemmed |
Central diabetes insipidus: alert for dehydration in very low birth weight infants during the neonatal period. A case report |
title_sort |
Central diabetes insipidus: alert for dehydration in very low birth weight infants during the neonatal period. A case report |
author |
Ferlin,Maria Lúcia Silveira |
author_facet |
Ferlin,Maria Lúcia Silveira Sales,Débora Simone Celini,Fábia Pereira Martins Martinelli Junior,Carlos Eduardo |
author_role |
author |
author2 |
Sales,Débora Simone Celini,Fábia Pereira Martins Martinelli Junior,Carlos Eduardo |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Ferlin,Maria Lúcia Silveira Sales,Débora Simone Celini,Fábia Pereira Martins Martinelli Junior,Carlos Eduardo |
dc.subject.por.fl_str_mv |
Diabetes insipidus, neurogenic Infant, very low birth weight Hypernatremia Dehydration Infant, newborn |
topic |
Diabetes insipidus, neurogenic Infant, very low birth weight Hypernatremia Dehydration Infant, newborn |
description |
CONTEXT: Central diabetes insipidus (CDI) is a rare cause of hypernatremia during the neonatal period. The diagnosis is particularly difficult in very low birth weight (VLBW) newborns. CASE REPORT: We report on a preterm newborn who presented CDI soon after birth. On the third day of life, signs of dehydration were present despite normal fluid supply. The diuresis rate was 4.4 ml/kg/h. Although the fluid supply was then increased, the dehydration continued, with hypernatremia, normal glycemia, diuresis of 7.4 ml/kg/h and urine density of 1005 mOsmol/l. Thus, a diagnostic hypothesis of diabetes insipidus was raised. A test with a nasal vasopressin analogue (dDAVP) was performed and CDI was confirmed. Reduction of the fluid supply became possible through appropriate treatment. CONCLUSION: The diagnosis of CDI is rarely made during the neonatal period, especially in VLBW newborns, because of the difficulty in detecting elevated diuresis. Persistent hypernatremia, usually accompanied by hyperthermia despite abundant fluid supply, weight loss and low urine osmolality are important signs of alert. |
publishDate |
2015 |
dc.date.none.fl_str_mv |
2015-02-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/report |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
report |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802015000100060 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802015000100060 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/1516-3180.2012.6450001 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Associação Paulista de Medicina - APM |
publisher.none.fl_str_mv |
Associação Paulista de Medicina - APM |
dc.source.none.fl_str_mv |
Sao Paulo Medical Journal v.133 n.1 2015 reponame:São Paulo medical journal (Online) instname:Associação Paulista de Medicina instacron:APM |
instname_str |
Associação Paulista de Medicina |
instacron_str |
APM |
institution |
APM |
reponame_str |
São Paulo medical journal (Online) |
collection |
São Paulo medical journal (Online) |
repository.name.fl_str_mv |
São Paulo medical journal (Online) - Associação Paulista de Medicina |
repository.mail.fl_str_mv |
revistas@apm.org.br |
_version_ |
1754209264332701696 |