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Pediatric Endocrinology (Expert Forum)
Diabetes Insipidus
Answered by
Deanna L Aftab Guy, MD - Short Stature, thyroid, Pituitary abnormalit, Puberty concerns, Rapid Growth, Adrenal problems, Parathyroid abnormal, Rickets and bone dis
Vanderbilt Children’s Hospital
Nashville - TN
Questions in the Pediatric Endocrinology forum are answered by Dr. Deanna L Aftab Guy, affiliated with Vanderbilt Children's Hospital. Topics covered include adrenal problems, diabetes insipidus, menstrual irregularities, obesity, parathyroid abnormalities, pituitary abnormalities, puberty concerns, rapid growth, rickets and bone disease, short stature, and thyroid.
Diabetes Insipidus
by Inky456, May 16, 2008 01:43PM
My son has a preliminary diagnosis of DI. That explains the urinary/thirst symptoms, but I have noticed a few other things I'd like to ask about. I will be discussing these with his Primary on Monday, but I wanted to ask about them beforehand, also. My son has lost 4 pounds in the past 2 months l(ow appetite), he has a low tolerance for cold temperatures most of the time (shivering, cold hands & feet) and I've noticed his gums have been bleeding a bit when he brushes. Could these symptoms be related or should I be concerned about other causes?
FYI, in every other aspect, he is a normal, very active child. No headaches, nausea or anything else of concern.
FYI, in every other aspect, he is a normal, very active child. No headaches, nausea or anything else of concern.
Doctor's Answer
by Deanna L Aftab Guy, MD, May 25, 2008 10:16AM
, May 25, 2008 10:16AM
To: lnky456
Often with DI there may be other hormonal abnormalities related to the pituitary. So the thyroid is a big one but also the acth cortisol pathway has got to be assessed, when do you see the endo? They can do this testing and it is important since if you are pituitary adrenally insufficient you can have problems during illness etc.
Also with DI I would insist on an mri of the pituitary, this has got to be done to rule out a central lesion, blood and urine done at the same time to look as osmolality and electrolytes is helpful but some endo docs need to do a water deprivation study.
I just had a little guy this week that we are doing one on, very similar urinating and drinking a ton, diabetes mellitus is a rare possibility but with normal sugars he is very perplexing so we have to bring him in and do a water deprivation study with checks every hour to see if he is indeed able to concentrate his urine and if he is able to hold onto water when needed.
Also with DI I would insist on an mri of the pituitary, this has got to be done to rule out a central lesion, blood and urine done at the same time to look as osmolality and electrolytes is helpful but some endo docs need to do a water deprivation study.
I just had a little guy this week that we are doing one on, very similar urinating and drinking a ton, diabetes mellitus is a rare possibility but with normal sugars he is very perplexing so we have to bring him in and do a water deprivation study with checks every hour to see if he is indeed able to concentrate his urine and if he is able to hold onto water when needed.
