LM Wong, KY Lau, K Tse

Abstract

Central diabetes insipidus is a rare disease in childhood and adolescence. This case report described a 13-year-old boy with polyuria and polydipsia for 2 years and water deprivation test confirmed central diabetes insipidus. Magnetic resonance imaging of brain revealed absence of posterior pituitary bright spot in T1-weighted image but otherwise normal study. The finding of 'idiopathic' central diabetes insipidus posed special challenge in subsequent follow-up in order to detect evolving anterior pituitary endocrinopathy. Also it is unclear about the frequency of serial imaging study of the brain so as to reveal possible neoplastic tissue. Besides, it is essential to disclose the nature of the findings and the follow-up plan to patient without causing undue anxiety.

中樞性尿崩症在兒童和青少年中罕見。在此報告一個 13 歲男孩多尿、煩渴 2 年，禁水試驗證實中樞性尿崩症腦部核磁共振顯示 T1 加權相垂體後葉亮點缺失，其他無異常發現。發現 "特發性" 中樞性尿崩症一定要定期隨診，以便發現進展的垂體前葉內分泌疾病。但是目前尚不清楚多長時間進行一次腦部影像學檢查可以避免漏診腫瘤。此外，應該向病人告知病情及隨診計劃，同時避免引起過度的焦慮。